Healthcare Provider Details

I. General information

NPI: 1952821076
Provider Name (Legal Business Name): JAYME LEIGH YAO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE STREET
PHILADELPHIA PA
19104-4206
US

IV. Provider business mailing address

3400 SPRUCE STREET DULLES BLDG, SUITE 680
PHILADELPHIA PA
19104-4206
US

V. Phone/Fax

Practice location:
  • Phone: 215-349-8310
  • Fax: 215-893-7270
Mailing address:
  • Phone: 215-349-8310
  • Fax: 215-893-7270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN670723
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: