Jacob, Mary Anne

Jacob, Mary Anne is an individual health care provider with primary practice located at 6545 France Avenue South Suite 540, Edina MN 55435. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Reproductive Endocrinology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is her primary health care specialty. Jacob, Mary Anne can be contacted via phone (952) 927-4045.

Contact Information

Primary practice address
6545 France Avenue South Suite 540 Edina MN 55435
Phone: (952) 927-4045
Fax: (952) 924-4133
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 41934 Minnesota
Allopathic & Osteopathic Physicians / Reproductive Endocrinology 207VE0102X 41934 Minnesota

Profile Details

NPI number 1659348399
LBN Legal business name Jacob, Mary Anne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2006
Last updated Apr 4th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659348399 NPPES
Minnesota Other 11D21JA BLUE CROSS/BLUE SHIELD
Minnesota Other HP29251 BLUE CROSS/BLUE SHIELD
Minnesota MEDICAID 252025700 BLUE CROSS/BLUE SHIELD

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