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General NPI Number Information
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NPI Number | 1144195165
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Entity Type | Individual
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Provider Name | MRS. PAIGE JACOBSON
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Gender | Female
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 2436 40TH AVE SE
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City | ROCHESTER
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State | MN
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Zip | 55904-2729
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Country | US
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Telephone | 507-398-8156
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Fax |
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Provider Business Mailing Address
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Address Line | 2436 40TH AVE SE
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City | ROCHESTER
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State | MN
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Zip | 55904-2729
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 2488777
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License Number State | MN
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