Most Relevant Information
Provider Data
| NPI Number: | 1003360991 |
| Provider Name: | MATTHEW JACOBSON APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 25098.1537 |
Most Important Dates
| Enumeration Date: | 08/08/2016 |
| Last Updated: | 04/05/2019 |
Provider Practice Location
108 20TH STREET
TORRINGTON
WY
824402812
Practice Location Phone/Fax
| Phone: | 3072690947 |
| Fax: |
Provider Mailing Location
108 20TH STREET
TORRINGTON
WY
824402812
Provider Mailing Phone/Fax
| Phone: | 3072690947 |
| Fax: |