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General NPI Number Information
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NPI Number | 1578959847
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Entity Type | Individual
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Provider Name | JESSICA P JACOBSON D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 1630 S 70TH ST STE 202
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City | LINCOLN
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State | NE
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Zip | 68506-1500
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Country | US
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Telephone | 531-254-5458
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Fax | 531-254-5065
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Provider Business Mailing Address
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Address Line | 1630 S 70TH ST STE 202
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City | LINCOLN
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State | NE
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Zip | 68506-1500
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Country | US
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Telephone | 402-890-6249
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Fax | 531-254-5065
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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 | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 2369
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License Number State | NE
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