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NPI Code Detail

MEDICARE: MS. JESSIE MARIE PEARSE CRNA

MEDICARE:  MS. JESSIE MARIE PEARSE  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 Anesthetist0994424CO
2367500000XCertified Registered Nurse Anesthetist171864AK

General Provider Information

NPI Number : 1871057364
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JESSIE MARIE PEARSE CRNA
Provider Business Mailing Address
First Line : 9600 BURNING BUSH DR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-1246
Country : US
Telephone Number : 303-870-3281
Fax Number :
Provider Business Practice Location Address
First Line : 4315 DIPLOMACY DR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-5926
Country : US
Telephone Number : 907-563-2662
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2019
Last Update Date : 03/20/2023

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Directions to “ MS. JESSIE MARIE PEARSE CRNA” Practice Location

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