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NPI 1427112499

NPI 1427112499 : KARLI JACOBSON PA-C : SALIDA, CO

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General NPI Number Information
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    NPI Number           |    1427112499
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    Entity Type          |    Individual 
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    Provider Name        |    KARLI JACOBSON PA-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/21/2006
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    Last Update Date     |    07/11/2023
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Provider Practice Location Address
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    Address Line         |    550 W HWY 50 
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    City                 |    SALIDA
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    State                |    CO
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    Zip                  |    81201-2238
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    Country              |    US
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    Telephone            |    719-530-2020
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    Fax                  |    719-530-2021
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Provider Business Mailing Address
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    Address Line         |    550 W HWY 50 
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    City                 |    SALIDA
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    State                |    CO
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    Zip                  |    81201-2238
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    Country              |    US
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    Telephone            |    719-530-2020
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    Fax                  |    719-530-2021
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    PA-1345
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    License Number State |    CO
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