Individual
JACOB D. THARPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
119 BELMONT ST, WORCESTER, MA 01605-2903
(508) 334-8297
(508) 334-8204
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN268765
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110106931A
—
MA
Enumeration date
01/16/2007
Last updated
12/01/2020
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