Individual
MS. BECKY J JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP APRN
Contact information
Practice address
4403 HARRISON BLVD, SUITE 4625, OGDEN, UT 84403
(801) 387-4800
(801) 387-4805
Mailing address
2853 MARILYN DR, OGDEN, UT 84403-0463
(801) 399-4263
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2112744405
UT
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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