CARMEN JEAN JACOBSON


Address: 2550 University Ave W, Suite 110n, Saint Paul, MN 55114-1052
Phone: 6516025311

CARMEN JEAN JACOBSON (NPI# 1063510550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063510550
Entity Type Individual
Full Name CARMEN JEAN JACOBSON
Other Name CARMEN LARSON
Credential P.A.-C
Practice Address 2550 University Ave W
Suite 110n
Saint Paul
MN 55114-1052
Practice Telephone 6516025311
Practice Fax Number 6512226786
Mailing Telephone 6516025311
Mailing Fax Number 6512226786
Enumeration Date 2006-09-20
Last Update Date 2013-08-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
9775 MN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN 127392200 05

Office Location

Street Address 2550 UNIVERSITY AVE W
SUITE 110N
City SAINT PAUL
State MN
Zip Code 55114-1052

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396747143 Colleen Rae Caspers Nurse Practitioner 2550 University Ave W, Suite 423 South, Saint Paul, MN 55114-1052 2005-08-11
1538707484 Hannah Weaver Nutritionist 2550 University Ave W, Saint Paul, MN 55114-1052 2019-12-11
1881251114 Miriam Rebecca Koch Gerber Psychologist 2550 University Ave W, Saint Paul, MN 55114-1052 2019-05-22
1578036042 Sarah Lazarewicz Social Worker 2550 University Ave W, Saint Paul, MN 55114-1052 2019-01-08
1215443049 Frederick Marcus Vickery Counselor 2550 University Ave W, Saint Paul, MN 55114-1052 2017-12-15
1790222438 Plastic Surgery Consultants Plastic Surgery 2550 University Ave W, Ste 110n, Saint Paul, MN 55114-1052 2017-01-19
1720537350 Kulule H Kenea Nurse Practitioner 2550 University Ave W, Suite 325s, Saint Paul, MN 55114-1052 2016-09-23
1992250187 Erin Ziolkowski Dietitian, Registered 2550 University Ave W, Saint Paul, MN 55114-1052 2016-08-17
1396196655 Alyssa Greene Counselor 2550 University Ave W, Saint Paul, MN 55114-1052 2016-06-28
1194174854 Accessible Space, Inc. Respite Care 2550 University Ave W, Suite 330n, Saint Paul, MN 55114-1052 2016-06-03
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790205698 Der Yang Registered Nurse 2356 University Ave W #220, Saint Paul, MN 55114 2017-06-21
1679949358 Mallory Haglund Counselor 284 West Rocky Lane, Boulder, NV 55114 2015-08-17
1083090880 Kayla Estenson Marriage & Family Therapist 2324 University Ave West, 120, St. Paul, MN 55114 2015-08-04
1184023772 Preetanjali Thakur Dentist 2550 University Avenue West Suite 189s, St Paul, MN 55114 2014-08-19
1023426210 Melanie Bayer Witthoft Social Worker 762 Transfer Road, 21, St. Paul, MN 55114 2014-07-31
1184046518 Britni Kelley Marriage & Family Therapist 821 Raymond Ave Ste 325, Saint Paul, MN 55114 2014-01-21
1205257581 Arti Kaul Dentist 808 Berry St, Apy 126, St Paul, MN 55114 2014-01-03
1588907109 Jesus M Calvillo Counselor 821 Raymond Ave Ste 230, Saint Paul, MN 55114 2013-04-02
1154669414 Caringhands Home Health Care Inc. Home Health 2233 University Ave West, Suite 330, St Paul, MN 55114 2013-01-22
1396021424 The Avalon Charter School Local Education Agency (LEA) 700 Glendale Street, Saint Paul, MN 55114 2011-11-03
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073051751 Hannah Elizabeth Rosenthal Danielson Physician Assistant 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 2017-02-02
1003258690 Jenny Rebecca Kluznik Physician Assistant 1619 Dayton Ave Ste 205, Saint Paul, MN 55104 2013-07-23
1538439534 Meghan Eileen Goff Physician Assistant 212 7th St E, Apt 204, Saint Paul, MN 55101-2373 2012-01-06
1003899527 Christopher Lawrence Kaye Physician Assistant 640 Jackson Street, Saint Paul, MN 55101 2005-11-29
1578113932 Alyssa Shenyeng Moualee Physician Assistant 1239 Payne Ave, Saint Paul, MN 55130-3667 2019-09-18
1790338754 Mikaela Pierson Physician Assistant 153 Cesar Chavez St, Saint Paul, MN 55107-2226 2019-07-18
1508425711 Sopida N/a Wunder Physician Assistant 1983 Sloan Pl Ste 11, Saint Paul, MN 55117-2004 2019-06-11
1780159533 Andrew Kenneth Gernand Physician Assistant 640 Jackson St, Saint Paul, MN 55101-2595 2018-10-08
1205350204 Soua Vang Physician Assistant 1983 Sloan Pl Ste 1, Saint Paul, MN 55117-2095 2017-08-01
1588184634 Katharine Elizabeth Boyd Physician Assistant 333 Smith Ave N, Saint Paul, MN 55102-2344 2017-06-20
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Competitor

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City SAINT PAUL
Zip Code 55114

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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