Jacobson, Kimberly A
Jacobson, Kimberly A is an individual health care provider with primary practice located at 347 North Smith Avenue Childrens Specialty Clinic Hematology Oncology Stpl, St Paul MN 55102. 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, Kimberly A can be contacted via phone (651) 220-6732.Contact Information
Primary practice address
347 North Smith Avenue Childrens Specialty Clinic Hematology Oncology Stpl
St Paul MN 55102
Phone: (651) 220-6732
Fax: (651) 220-6005
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | R1469844 | Minnesota |
Profile Details
| NPI number | 1871553883 |
|---|---|
| LBN Legal business name | Jacobson, Kimberly A |
| Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Oct 16th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871553883 | NPPES |
| Minnesota | MEDICAID | 847981000 |
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