Jacobsen, Kimberly K

Jacobsen, Kimberly K is an individual health care provider with primary practice located at 14700 28Th Ave N Ste 20 , Plymouth MN 55447-4876. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is her primary health care specialty. Jacobsen, Kimberly K can be contacted via phone (763) 559-3779.

Contact Information

Primary practice address
14700 28Th Ave N Ste 20 Plymouth MN 55447-4876
Phone: (763) 559-3779
Fax: (763) 450-3986
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207LC0200X 66773 Wisconsin
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 78154 Minnesota
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 66773 Wisconsin

Profile Details

NPI number 1851786248
LBN Legal business name Jacobsen, Kimberly K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2015
Last updated Nov 10th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851786248 NPPES
Wisconsin MEDICAID 1851786248

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