Individual
MARY A JACOBSEN
Active
Individual
MARY A JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1202472
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ARNP1202472
FL LICENSE
FL
01
—
G0435
FL BCBS
FL
01
—
P00287820
MEDICARE RAILROAD
—
Enumeration date
01/26/2007
Last updated
07/08/2007
Update your record
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