MRS. LANA RAE JACOBSON


Address: 1401 Nw 9th Street, Grand Rapids, MN 55744
Phone: 2183274961

MRS. LANA RAE JACOBSON (NPI# 1275883266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275883266
Entity Type Individual
Full Name MRS. LANA RAE JACOBSON
Credential FAMILY NURSE PRACTIT
Practice Address 1401 Nw 9th Street
Grand Rapids
MN 55744
Mailing Address 1542 Golf Course Rd Ste 203
Grand Rapids
MN 55744-3557
Practice Telephone 2183274961
Mailing Telephone 2183224900
Enumeration Date 2012-09-17
Last Update Date 2020-10-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 120342-4 MN Nursing Service Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
0257857-22 MN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1401 NW 9TH STREET
City GRAND RAPIDS
State MN
Zip Code 55744

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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Competitor

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City GRAND RAPIDS
Zip Code 55744

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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