Jacobsen, Theresa A

Jacobsen, Theresa A is an individual health care provider with primary practice located at 2304 E Geneva Dr , Tempe AZ 85282-4147. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Jacobsen, Theresa A can be contacted via phone (480) 878-5306.

Contact Information

Primary practice address
2304 E Geneva Dr Tempe AZ 85282-4147
Phone: (480) 878-5306
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN063885 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP2138 Arizona

Profile Details

NPI number 1689667883
LBN Legal business name Jacobsen, Theresa A
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Jul 24th, 2017 - about 9 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 1689667883 NPPES
Arizona MEDICAID 938798-03
Arizona Other 2Z9842

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