Individual provider · NPI-1

Kristina Kahle Jacobsen, R.T.(R)

Radiologic Technologist · Phoenix, AZ

NPI number1134624133
StatusActive
Last updated in NPPESMar 29, 2018

Details

NPI
1134624133
Entity type
Individual (NPI-1)
Name
Kristina Kahle Jacobsen
Credential
R.T.(R)
Sex
Female
Sole proprietor
No
Enumeration date
Mar 29, 2018
Last updated
Mar 29, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
247100000X Radiologic Technologist564028AZYes

Practice location

350 W Thomas Rd
Phoenix, AZ 85013-4409

Phone 602-406-6700

Mailing address

232 W 9th Pl N
Mesa, AZ 85201-4261

Phone 480-235-4634

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