| NPI | 1285930339 |
|---|---|
| Former Name | DEANA FANTOM JACOBSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO APN.0100067-CRNA) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 127479) |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2022-05-16 |