Provider Demographics
NPI:1609655943
Name:TOBIN, JACOB M (RN)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:M
Last Name:TOBIN
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Gender:M
Credentials:RN
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6621
Mailing Address - Fax:570-271-6762
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-1112
Practice Address - Country:US
Practice Address - Phone:570-271-6621
Practice Address - Fax:570-271-6762
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2025-07-16
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Provider Licenses
StateLicense IDTaxonomies
PARN712772367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered