Individual
ANNA LOUISE JACOBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
325 PARK ST, LEBANON, OR 97355-4229
(541) 451-7200
Mailing address
PO BOX 1193, CORVALLIS, OR 97339-1193
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201809831NP-PP
OR
Other
Enumeration date
11/02/2018
Last updated
11/04/2020
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