Individual
JACOB WAINWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5054
(850) 431-1155
Mailing address
7097 SHADY GROVE WAY, TALLAHASSEE, FL 32312-8083
(850) 447-1864
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11023622
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/17/2022
Last updated
04/08/2023
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