Provider Demographics
NPI:1649502196
Name:LEVSEN, JACOB N (BCHIS)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:N
Last Name:LEVSEN
Suffix:
Gender:M
Credentials:BCHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3723
Mailing Address - Country:US
Mailing Address - Phone:641-840-2240
Mailing Address - Fax:
Practice Address - Street 1:221 1ST AVE W
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3723
Practice Address - Country:US
Practice Address - Phone:641-840-2240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00907237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist