Individual
JACOB HEETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
907 SUMNER ST. SUITE M201, GUARDIAN ANESTHESIA INC., STOUGHTON, MA 02072
(781) 344-2325
(781) 341-8544
Mailing address
1229 MADISON ST, STE 1440, SEATTLE, WA 98104-3538
(781) 344-2325
(781) 341-8544
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2297563
MA
367500000X
Certified Registered Nurse Anesthetist
RN2297563
MA
Other
Enumeration date
12/13/2014
Last updated
07/29/2016
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