Jacobsen, Peggy Elene

Jacobsen, Peggy Elene is an individual health care provider with primary practice located at 195 W 7200 S , Midvale UT 84047-3703. She recently has only one registered license in Nursing Service Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Jacobsen, Peggy Elene can be contacted via phone (801) 565-6900.

Contact Information

Primary practice address
195 W 7200 S Midvale UT 84047-3703
Phone: (801) 565-6900
Fax: (801) 569-0899
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X 1927543102 Utah

Profile Details

NPI number 1356311781
LBN Legal business name Jacobsen, Peggy Elene
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Jul 8th, 2007 - about 17 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 1356311781 NPPES
Utah Other 942938348014 CHAMPUS
Utah Other 751659 CHAMPUS
Utah Other 107032218101 CHAMPUS

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