Individual
SHERLY C JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
44201 DEQUINDRE ROAD, TROY, MI 48085-1117
(248) 898-5000
Mailing address
3601 W 13 MILE ROAD, 400 FSC - PCS, ROYAL OAK, MI 48073-6769
(248) 423-2481
(248) 423-2576
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704210896
MI
Other
Enumeration date
05/10/2006
Last updated
07/08/2007
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