Individual
ANITA N JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHAM.D.
Contact information
Practice address
7 GREENHOUSE RD, 295B, KINGSTON, RI 02881-2018
(401) 874-2641
(401) 874-5670
Mailing address
7 GREENHOUSE RD, KINGSTON, RI 02881-2018
(401) 874-2641
(401) 572-3351
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH04030
RI
1835P1200X
Pharmacotherapy Pharmacist
RPH04030
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH04030
LICENSE
RI
Enumeration date
12/25/2009
Last updated
12/15/2023
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