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NPI Code Detail

MEDICARE: MS. JENNIFER G RESTA CRNA

MEDICARE: MS. JENNIFER G RESTA CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianRN-0001188030VA
2207L00000XAnesthesiology PhysicianCRNA 0024166056VA
3367500000XCertified Registered Nurse Anesthetist0024166056VA

General Provider Information

NPI Number : 1346249810
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER G RESTA CRNA
Provider Business Mailing Address
First Line : 2101 E JEFFERSON ST
Second Line : KAISER PERMANENTE MEDICARE ENROLLMENT
City : ROCKVILLE
State : MD
Zip : 20852-4908
Country : US
Telephone Number : 301-816-2424
Fax Number :
Provider Business Practice Location Address
First Line : 8008 WESTPARK DR
Second Line : KAISER PERMANENTE TYSONS CORNER MEDICAL CENTER
City : MC LEAN
State : VA
Zip : 22102-3109
Country : US
Telephone Number : 703-287-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2005
Last Update Date : 03/01/2013

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