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NPI Code Detail

MEDICARE: JESSICA CHING LAI CRNA

MEDICARE: JESSICA CHING LAI 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
1367500000XCertified Registered Nurse Anesthetist156429NC
2163W00000XRegistered Nurse304553NC

General Provider Information

NPI Number : 1477377190
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA CHING LAI CRNA
Provider Business Mailing Address
First Line : 1598 BRIARVISTA WAY NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3638
Country : US
Telephone Number : 919-685-6821
Fax Number :
Provider Business Practice Location Address
First Line : 2301 ERWIN RD
Second Line :
City : DURHAM
State : NC
Zip : 27705-4699
Country : US
Telephone Number : 919-684-8111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2024
Last Update Date : 12/09/2025

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