Individual provider · NPI-1

Tiffany Nicole Jacobson, Cosmetic Tattooer

Specialist/Technologist, Other · Bowie, MD

NPI number1609649466
StatusActive
Last updated in NPPESNov 5, 2023

Details

NPI
1609649466
Entity type
Individual (NPI-1)
Name
Ms. Tiffany Nicole Jacobson
Credential
Cosmetic Tattooer
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 3, 2023
Certification date
Nov 5, 2023
Last updated
Nov 5, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246Z00000X Specialist/Technologist, Other1236001387VAYes

Practice location

12415 Quiet Owl Ln
Bowie, MD 20720-4304

Phone 202-699-0664

Mailing address

12415 Quiet Owl Ln
Bowie, MD 20720-4304

Phone 202-699-0664

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Other Specialist/Technologist, Other providers in Bowie, MD