Healthcare Provider Details

I. General information

NPI: 1043171002
Provider Name (Legal Business Name): JAKE MICHAEL CURTIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 VETERANS DR
FLORENCE AL
35630-4928
US

IV. Provider business mailing address

1701 VETERANS DR
FLORENCE AL
35630-4928
US

V. Phone/Fax

Practice location:
  • Phone: 256-629-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-176313
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: