Individual provider · NPI-1

Jedd Easton Dillman, CRNA

Nurse Anesthetist, Certified Registered · Livingston, NJ

NPI number1568098655
StatusActive
Last updated in NPPESNov 15, 2022

Details

NPI
1568098655
Entity type
Individual (NPI-1)
Name
Jedd Easton Dillman
Credential
CRNA
Sex
Male
Sole proprietor
No
Enumeration date
Mar 20, 2020
Certification date
Nov 15, 2022
Last updated
Nov 15, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified Registered26NJ01040700NJYes
163W00000X Registered Nurse26nr19255000NJ
367500000X Nurse Anesthetist, Certified Registered728906NY

Practice location

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Phone 973-322-5180

Mailing address

1301 Concord Ter
Sunrise, FL 33323-2843

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