Individual
MR. JASON PAUL ANNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1705 TARBORO ST SW, WILSON, NC 27893-3428
(252) 399-8040
Mailing address
3100 SPRING FOREST RD, SUITE 130, RALEIGH, NC 27616-2880
(919) 873-9533
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
172062
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
073396
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052801
—
NC
01
—
P00600549
RAILROAD MEDICARE
NC
Enumeration date
08/05/2006
Last updated
04/10/2015
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