Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 06073 | OH |
NPI | 1093713992 |
---|---|
Provider Name | Cori L Jacobson |
First Address | Toledo, OH 43606-3895 |
Second Address | Perrysburg, OH 43551-7288 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 05/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000201559 | ANTHEM (01) | |
05225 | PARAMOUNT (01) | |
2223534 | (05) | OH |
344428256 | BEECH STREET (01) | CA |
344428256 | HEALTH NET (01) | OH |
344428256072 | CARESOURCE (01) | |
4285606 | (05) | MI |
68458 | (02) | OH |