Elizabeth Jean Jacobsen, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP138299 Issued in TX

Practice address

5510 Summerhill Rd
Texarkana, TX 75503-1822

Phone

(903) 278-9566

NPI assigned

Aug 8, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1801441597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 SUMMERHILL RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031822",
            "telephone_number": "903-278-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 SUMMERHILL RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031822",
            "telephone_number": "903-278-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "ELIZABETH",
        "middle_name": "JEAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Texarkana",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5510 Summerhill Rd",
            "city": "Texarkana",
            "state": "TX",
            "country_code": "US",
            "postal_code": "755031822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gary L Jackson, CRNA
• Juliet Noelle Jackson
• Noel R Jackson, CRNA
• Randy Alan Jackson, M.D.
• Job Jacob, M.D.
• Erik Jacobsen, MD
• Jacqueline S O'Donald, M.D., PA
• James M Hurley MD PA (Texarkana Cardiology Associates)
• Joseph D James, D.D.S.
• Paul Mitchell James, CRNA

• Family Nurse Practitioner in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.