Provider Demographics
NPI:1699523944
Name:JACOBSON, BRITNI LEIGH
Entity type:Individual
Prefix:MS
First Name:BRITNI
Middle Name:LEIGH
Last Name:JACOBSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 E 46TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-4850
Mailing Address - Country:US
Mailing Address - Phone:539-766-4821
Mailing Address - Fax:
Practice Address - Street 1:5310 E 31ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5012
Practice Address - Country:US
Practice Address - Phone:918-600-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist