Loren Henning Jacobsen, MD
Individual provider Active NPI Family Medicine Physician · Broken Bow, NE
NPI 1609937598 · NPPES record last updated Jul 13, 2007
Key facts
- NPI
- 1609937598
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 11678 (NE)
- Practice address
- 145 Memorial Dr
Broken Bow, NE 68822-1378 - Phone
- (308) 872-2486
- Fax
- (308) 872-2027
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11678 | NE | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11678 | NE | Yes |
Addresses
Primary practice location
145 Memorial Dr
Broken Bow, NE 68822-1378
Mailing address
PO Box 690
Broken Bow, NE 68822-0690
Phone (308) 872-6283
Other providers in Broken Bow, NE
- Kalli Horky
- Colby John Howard
- Megan Jo Howard
- Angie Marie Hunt
- Teddy Eugene Hunt
- Julie Anne Jacobson
- Jennie M Melham Memorial Medical Center
- Jennie M Melham Memorial Medical Center
- Jennie M Melham Memorial Medical Center
- Jennie M Melham Memorial Medical Center
All providers in Broken Bow, NE · Family Medicine Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.