Provider Demographics
NPI:1497177760
Name:OPOLINER, JACOB J (CRNA)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:J
Last Name:OPOLINER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3100 SPRING FOREST RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2880
Mailing Address - Country:US
Mailing Address - Phone:919-882-0707
Mailing Address - Fax:919-873-9821
Practice Address - Street 1:5801 BREMO RD
Practice Address - Street 2:AMERICAN ANESTHESIOLGY OF VIRGINIA, PC
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1907
Practice Address - Country:US
Practice Address - Phone:973-660-9334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA100110367500000X
VA0024171442367500000X
CA95000481367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered