| Flint Dean Jacobson, NP | |
|
166 S 5th St, Montpelier, ID 83254-4959 | |
| (208) 847-3847 | |
| Not Available |
| Full Name | Flint Dean Jacobson |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 166 S 5th St, Montpelier, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033837893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 73078 (Idaho) | Primary |
| Entity Name | Bear Lake County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174741441 PECOS PAC ID: 5395799860 Enrollment ID: O20071003000677 |
| Mailing Address | Practice Location Address |
|---|---|
| Flint Dean Jacobson, NP 166 S 5th St, Montpelier, ID 83254-4959 Ph: () - | Flint Dean Jacobson, NP 166 S 5th St, Montpelier, ID 83254-4959 Ph: (208) 847-3847 |
Alex Michael Carr, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 164 S 5th St, Montpelier, ID 83254 Phone: 208-847-1630 | |
Mina L Wayman, GNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 152 S 4th St, Montpelier, ID 83254 Phone: 435-755-6061 | |
Kasey L Ward, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 164 S 5th St, Montpelier, ID 83254 Phone: 208-847-1630 |