Individual
REBECCA JAHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4100 PARK FOREST DR STE 210, TRAVERSE CITY, MI 49684-7306
(231) 935-5770
(231) 935-0747
Mailing address
4100 PARK FOREST DR, SUITE 210, TRAVERSE CITY, MI 49684
(231) 935-5770
(231) 935-0747
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
243696
NC
367500000X
Certified Registered Nurse Anesthetist
4704154430
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.0020327
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430F364420
BCBSM
MI
05
—
4500919
—
MI
Enumeration date
03/10/2006
Last updated
09/01/2021
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