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General NPI Number Information
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NPI Number | 1265428734
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Entity Type | Individual
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Provider Name | JARED Y ROBERTSON III CRNA
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Gender | Male
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Dates
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Enumeration Date | 09/21/2005
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 149 DRINKWATER RD
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City | BAY ST LOUIS
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State | MS
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Zip | 39520-1658
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Country | US
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Telephone | 228-467-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 1514 JEFFERSON HWY
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City | NEW ORLEANS
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State | LA
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Zip | 70121-2429
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Country | US
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Telephone | 504-842-4000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 10597
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 5201
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4858A
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 24167318
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3625
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License Number State | SC
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Taxonomy #6
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 71550
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License Number State | NC
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Taxonomy #7
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 144482
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 901491
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License Number State | MS
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