Susan Lorraine Jacobsen

Primary specialty

Pulmonary Function Technologist Certified Respiratory TherapistTaxonomy code 2278P1006X

License

TT0001695 Issued in FL

Practice address

619 S Marion Ave
Lake City, FL 32025-5808

Phone

(386) 755-3016

NPI assigned

Sep 20, 2006

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

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922106350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7847 SW 44TH AVE",
            "city": "LAKE BUTLER",
            "state": "FL",
            "postal_code": "320547314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255808",
            "telephone_number": "386-755-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "SUSAN",
        "middle_name": "LORRAINE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2278P1006X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified, Pulmonary Function Technologist",
            "state": "FL",
            "license": "TT0001695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mardell Jackson
• Raven Jackson
• Stefanie M Jackson, ARNP
• Ta'Sheika Jackson
• Terries Jackson
• Rashad D James
• Stanley Janasiewicz
• Michael L Jarrell, DMD
• Richard N Jaskiewicz, MD
• Jean-Felert Cadet MD, PA

• Certified Respiratory Therapist in Lake City, FL
• Providers in Lake City, FL by specialty
• Certified Respiratory Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.