Individual
AMY JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHN
Contact information
Practice address
555 CEDAR ST, SAINT PAUL, MN 55101-2209
(651) 266-1346
Mailing address
555 CEDAR ST, SAINT PAUL, MN 55101-2209
(651) 266-1346
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R 194108-7
MN
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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