Provider Demographics
NPI:1871383273
Name:JOBE, ANNA (CRNA STUDENT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:JOBE
Suffix:
Gender:
Credentials:CRNA STUDENT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:JOBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:375 W 46TH ST APT 4W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-8342
Mailing Address - Country:US
Mailing Address - Phone:828-719-6870
Mailing Address - Fax:
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY866000367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered