MRS. RENEE ROSE JACOBSON (NPI# 1619196490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619196490 |
| Entity Type | Individual |
| Full Name | MRS. RENEE ROSE JACOBSON |
| Other Name | MRS. RENEE ROSE JACOBSON |
| Credential | FNP |
| Practice Address |
1701 E Front St Lb 106 Traverse City MI 49686-3016 |
| Practice Telephone | 2319951256 |
| Practice Fax Number | 2319951923 |
| Mailing Telephone | 2319951256 |
| Mailing Fax Number | 2319951923 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2008-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704147470 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871816678 | Renee M Jacobson | Occupational Therapist | 1356 Ne Hawthorne Ave, Hillsboro, OR 97124-2603 | 2010-03-08 |
| Street Address |
1701 E FRONT ST LB 106 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49686-3016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700033859 | Northwestern Michigan College | Clinic/Center | 1701 E Front St, L.b. 106, Traverse City, MI 49686-3016 | 2008-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245877208 | Jessica Marie Glowacki | Behavior Technician | 935 Hemlock St, Traverse City, MI 49686 | 2019-12-09 |
| 1568011542 | Joanne Kressley | Technician | 1693 Maylane Apt. 104, Traverse City, MI 49686 | 2019-09-11 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1245749225 | Margaret Anne Goss | Speech-Language Pathologist | 1105 E. Eighth Street, Traverse City, MI 49686 | 2017-09-22 |
| 1467981811 | Joan Joyce Shirilla | Social Worker | 2124 Twin Eagles Dr, Traverse City, MI 49686 | 2017-06-08 |
| 1770028763 | Rehab and Mobility Systems, LLC | Durable Medical Equipment & Medical Supplies | 707 Parsons, Traverse City, MI 49686 | 2016-12-29 |
| 1629511316 | Kaitlyn Grangood | Social Worker | 415 Munson Avenue, Ste 101, Traverse City, MI 49686 | 2016-11-29 |
| 1811441132 | Jeffrey D Goodwin | Counselor | 430 Fair St., Traverse City, MI 49686 | 2016-08-04 |
| 1053779918 | Thomas Osborne | Counselor | 2014 Phelps Rd., Traverse City, MI 49686 | 2016-02-08 |
| 1982079588 | Marsha Lynne Dallas | Counselor | 2240 South Airport Road, Traverse City, MI 49686 | 2015-12-08 |
| Find all providers in zip 49686 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639638588 | Shawn Ann Kintigh | Nurse Practitioner | 5041 N Royal Dr Ste 1, Traverse City, MI 49684-6986 | 2019-03-19 |
| 1134551492 | Karen Lynn Volas | Nurse Practitioner | 3865 W Front St, Traverse City, MI 49684-8153 | 2013-08-08 |
| 1275771370 | Danielle Emily Koch | Nurse Practitioner | 5191 Rosewood Dr, Traverse City, MI 49685-9137 | 2009-01-27 |
| 1144424219 | Linda Danielle Gottwald | Nurse Practitioner | 1105 Sixth St., Traverse City, MI 49684 | 2007-06-13 |
| 1023182078 | Laura A. Schmidt | Nurse Practitioner | 921 W Front St, Traverse City, MI 49684-2327 | 2006-11-20 |
| 1609985977 | Patricia Elaine Mcintosh | Nurse Practitioner | 10767 E Traverse Hwy, Traverse City, MI 49684-6219 | 2006-08-30 |
| 1730116732 | Gabrielle W Cochran | Nurse Practitioner | 1515 Cass Street Suite C, Traverse City, MI 49684-4156 | 2006-06-26 |
| 1730157652 | Jill Norene Polmateer | Nurse Practitioner | 1104 Cass St, Traverse City, MI 49684-3236 | 2006-03-08 |
| 1538131396 | Patricia Davis | Nurse Practitioner | 217 S Madison St, Traverse City, MI 49684-2320 | 2006-02-06 |
| 1437139318 | Camille Griswold | Nurse Practitioner | 1221 Sixth St, Suite 206, Traverse City, MI 49684-2701 | 2006-01-18 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49686 |
Please comment or provide details below to improve the information on MRS. RENEE ROSE JACOBSON.
| 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.