Jacob J Briscoe, CRNA
Nurse Anesthetist, Certified Registered in Poplar Bluff, MO. Individual provider (NPI-1).
NPI number1972736551
StatusActive
Last updated in NPPESSep 9, 2024
Details
- NPI
- 1972736551
- Entity type
- Individual (NPI-1)
- Name
- Jacob J Briscoe
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 28, 2009
- Certification date
- Sep 9, 2024
- Last updated
- Sep 9, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 2024007928 | MO | Yes |
| 367500000X | Nurse Anesthetist, Certified Registered | 041341872 | IL | |
| 367500000X | Nurse Anesthetist, Certified Registered | 209007627 | IL |
Practice location
3100 Oak Grove RdPoplar Bluff, MO 63901-1573
Phone 573-776-2000
Mailing address
1201 Hamer RdDyersburg, TN 38024-6908
Phone 309-210-6650
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All 21 Certified Registered Nurse Anesthetist providers in Poplar Bluff · All 1,814 providers in Poplar Bluff
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