Jacobson, Diana Lynn

Jacobson, Diana Lynn is an individual health care provider with primary practice located at 2152 S Vineyard Suite 129, Mesa AZ 85210-6871. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Jacobson, Diana Lynn can be contacted via phone (480) 732-0044.

Contact Information

Primary practice address
2152 S Vineyard Suite 129 Mesa AZ 85210-6871
Phone: (480) 732-0044
Fax: (480) 732-9333
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R.N.042819 PNP124 Arizona

Profile Details

NPI number 1386610822
LBN Legal business name Jacobson, Diana Lynn
Credentials R.N.,C.P.N.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Dec 1st, 2008 - about 18 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 1386610822 NPPES
Arizona MEDICAID 431528

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