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Individual

MR. JAKOB DILLON BURCHEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, CRNA

Contact information

Practice address
2900 16TH ST, BEDFORD, IN 47421-3510
(812) 276-4378
(812) 275-1246
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28273644A
IN
367500000X
Certified Registered Nurse Anesthetist
3017820
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300064779
IN
05
7100820520
KY
01
940070016
MEDICARE
IN
Enumeration date
05/25/2022
Last updated
04/06/2023
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