Individual
LORAN C JACOBS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
807 S PONDEROSA ST, PAYSON, AZ 85541-5542
(602) 273-6770
(602) 889-0483
Mailing address
5281 N 99TH AVE, STE 100, GLENDALE, AZ 85305-2209
(623) 241-6160
(623) 691-8502
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4704149628
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA0562
AZ
367500000X
Certified Registered Nurse Anesthetist
RN151239
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320385
—
AZ
01
—
4704149628
LICENSE NUMBER
MI
Enumeration date
05/30/2006
Last updated
04/27/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us