Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Paulk, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1215227202

Jacob Paulk, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Tifton, Georgia. Qualified in 2010, 16 years ago. Practices with Coffee Regional Medical Center Inc, a 29-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
16
Licensed in
GA
In the registry since
2011
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

901 18th St E
Tifton, GA 31794-3648
Phone: (229) 353-6124
Fax: (229) 353-7722
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence RN181759 (GA)

Record details

NPI number1215227202
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedApril 12, 2011
Last updated in NPPESDecember 16, 2020
Certification dateDecember 16, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Coffee Regional Medical Center Inc — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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