Individual
JON BOYD POULSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
401 MATTHEW ST, MARIETTA, OH 45750-1635
(740) 568-5427
Mailing address
101 RIVERSIDE LN, MARIETTA, OH 45750-1448
(740) 336-9201
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
56808
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.06711
OH
367500000X
Certified Registered Nurse Anesthetist
RN233430
OH
Other
Enumeration date
06/21/2006
Last updated
10/27/2022
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