Individual
JARROD PREBOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
553 HILLSIDE VIEW DR, DUNCANSVILLE, PA 16635-7459
(814) 207-3903
Mailing address
6709 ACADEMY RD NE STE A, ALBUQUERQUE, NM 87109-3363
(814) 207-3903
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
69004
NM
367500000X
Certified Registered Nurse Anesthetist
69004
NM
Other
Enumeration date
09/07/2022
Last updated
11/01/2022
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