Individual
JACOB NIBARGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1600 WALLACE BLVD, AMARILLO, TX 79106-1799
(817) 917-2465
Mailing address
6400 BELL ST, APARTMENT 6101, AMARILLO, TX 79109-6638
(817) 917-2465
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP126573
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/02/2014
Last updated
02/16/2015
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