Individual
JACOB TODD ALBERDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
900 PEELER ST STE B, KALAMAZOO, MI 49008-2380
(269) 345-8618
(269) 345-1508
Mailing address
900 PEELER ST STE B, KALAMAZOO, MI 49008-2380
(269) 345-8618
(269) 345-1508
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
28233723
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
4704275581
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704275581
MICHIGAN LICENSE
MI
Enumeration date
01/11/2017
Last updated
12/13/2018
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