Healthcare Provider Details

I. General information

NPI: 1245459684
Provider Name (Legal Business Name): KRISTINE ELIZABETH JACOBSON APRN-CNS/CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 5TH ST NE STE 16
BARBERTON OH
44203-3017
US

IV. Provider business mailing address

1650 17TH ST
CUYAHOGA FALLS OH
44223-1806
US

V. Phone/Fax

Practice location:
  • Phone: 330-615-3070
  • Fax: 234-312-2427
Mailing address:
  • Phone: 330-322-0130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN.CNP.0032224
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberAPRN.CNS.09037
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License NumberAPRN.CNS.09037
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code364SN0800X
TaxonomyNeuroscience Clinical Nurse Specialist
License NumberAPRN.CNS.09037
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: