Individual
MRS. ZEENA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140
(215) 707-3326
(215) 707-8028
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3326
(215) 707-8028
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
525412-1
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
RN647780
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN647780
RN647780
PA
Enumeration date
10/27/2006
Last updated
05/21/2018
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