Carlene Jacobson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

7612108-3102 Issued in UT

Practice address

670 E 3900 S Ste 310
Salt Lake City, UT 84107-1981

Phone

(801) 266-3939

NPI assigned

Sep 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1801673017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1667 W 400 N",
            "city": "MARRIOTT SLATERVILLE",
            "state": "UT",
            "postal_code": "844043412",
            "telephone_number": "801-205-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 E 3900 S STE 310",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841071981",
            "telephone_number": "801-266-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "CARLENE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "846611",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "7612108-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Clark Jacobsen, LCSW
• Stephanie Dawn Jacobsen
• Kristin Jacobson Messner, SLP
• Bruce Kenneth Jacobson, PH.D., P.C.
• Bryanna Jacobson
• Deborah Lynn Jacobson, MD
• Hannah Qian Ying Jacobson
• Howard Scott Jacobson III
• Jay A Jacobson, MD
• Kirsten Jacobson

• Registered Nurse in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Registered Nurse in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.