Jacob D Hantla, CRNA
Nurse Anesthetist, Certified Registered in Chandler, AZ. Individual provider (NPI-1).
NPI number1598043572
StatusActive
Last updated in NPPESSep 16, 2011
Details
- NPI
- 1598043572
- Entity type
- Individual (NPI-1)
- Name
- Jacob D Hantla
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 25, 2011
- Last updated
- Sep 16, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | CRNA0786 | AZ | Yes |
| 163W00000X | Registered Nurse | RN139385 | AZ | |
| 163W00000X | Registered Nurse | RN9307995 | FL |
Practice location
1849 W Orchid LnChandler, AZ 85224-9034
Phone 480-241-3769 · Fax 480-393-4109
Mailing address
1849 W Orchid LnChandler, AZ 85224-9034
Phone 480-241-3769 · Fax 480-393-4109
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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