Individual provider · Type 1 NPI
Jacob Allen Burgoon
Student in an Organized Health Care Education/Training Program · Circle Pines, MN
NPI number
1437779212
Active
Practice location
310 Little John Dr
Circle Pines, MN 55014-1721
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Athletic Trainer | 2255A2300X | None listed |
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
About NPI 1437779212
Jacob Allen Burgoon's National Provider Identifier is 1437779212, issued on Apr 21, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Circle Pines, MN. The record was last updated on Apr 21, 2020.