Holly Jacobsen

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

C-APN.0003978-C-NP Issued in CO

Practice address

1230 Tenderfoot Hill Rd Ste 255
Colorado Springs, CO 80906-7393

Phone

(719) 350-6830

NPI assigned

May 6, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Holly Jacobsen Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1710623327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 TENDERFOOT HILL RD STE 255",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809067393",
            "telephone_number": "719-350-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 TENDERFOOT HILL RD STE 255",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809067393",
            "telephone_number": "719-350-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "CO",
            "license": "C-APN.0003978-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0003978",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "C-APN.0003978-C-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "JACOBSEN",
            "credential": "FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Marlicia Jacobs
• Mason Jacobs
• Raquel Jacobs
• Stephen J Jacobs, M.D.
• Alesia Marie Jacobsen, RDH
• Sara Denise Jacobsen, RN
• Susan Marie Jacobsen, ATR-BC, LPC
• Alicia Vashti Jacobson, RBT
• Ammon Jacobson, D.C.
• Garrett Jacobson

• Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.