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

Mr. Jacob Andrew Kingston, RN

Individual provider Certified Registered Nurse Anesthetist · NPI 1366019796

Mr. Jacob Andrew Kingston, RN is a Certified Registered Nurse Anesthetist (CRNA) in Plymouth, Minnesota. Qualified in 2021, 5 years ago. Practices with University Anesthesia Providers LLC, a 332-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
5
Licensed in
MN
In the registry since
2021
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

14700 28th Ave N Ste 20
Plymouth, MN 55447-4876
Phone: (763) 559-3779
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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 2630 (MN)

Record details

NPI number1366019796
Entity typeIndividual (Type 1)
GenderMale
Credentials RN
Sole proprietorNo
NPI enumeratedJune 4, 2021
Last updated in NPPESMay 30, 2024
Certification dateMay 30, 2024

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice University Anesthesia Providers Llc — 332 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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