Active NPI
Liane Jacobson
- Ambulatory Care Registered Nurse
- Lawton, OK
National Provider Identifier
1013424027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Registered Nurse
- License
- 645341
- Practice address
- 1515 Laurie Tatum Road
Adult Care Clinic 2
Lawton, OK 73507 - Phone
- (580) 354-5000
- NPI assigned
- Dec 29, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | 645341 | TX | Primary |
Addresses
Primary practice location
1515 Laurie Tatum Road
Adult Care Clinic 2
Lawton, OK 73507
Mailing address
1515 Laurie Tatum Road
Adult Care Clinic 2
Lawton, OK 73507
Phone (580) 354-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 645341 | TX | MD | Ambulatory Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514505600000",
"number": "1013424027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 LAURIE TATUM ROAD",
"address_2": "ADULT CARE CLINIC 2",
"city": "LAWTON",
"state": "OK",
"postal_code": "73507",
"telephone_number": "580-354-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 LAURIE TATUM ROAD",
"address_2": "ADULT CARE CLINIC 2",
"city": "LAWTON",
"state": "OK",
"postal_code": "73507",
"telephone_number": "580-354-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "LIANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-29",
"last_updated": "2017-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "163WP2201X",
"taxonomy_group": "",
"desc": "Registered Nurse, Ambulatory Care",
"state": "TX",
"license": "645341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.