Provider Demographics
NPI:1578959847
Name:JACOBSON, JESSICA P (DO)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:P
Last Name:JACOBSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1630 S 70TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1500
Mailing Address - Country:US
Mailing Address - Phone:402-890-6249
Mailing Address - Fax:531-254-5065
Practice Address - Street 1:1630 S 70TH ST STE 202
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1500
Practice Address - Country:US
Practice Address - Phone:531-254-5458
Practice Address - Fax:531-254-5065
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-13
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE2369207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2017014908OtherOTOLARYNGOLOGY, COSMETIC SURGERY
NE2369OtherOTOLARYNGOLOGY, COSMETIC SURGERY