Healthcare Provider Details

I. General information

NPI: 1578548665
Provider Name (Legal Business Name): JO ANN ELIZABETH WRIGHT CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JO ANN ELIZABETH SERSLAND CRNA

II. Dates (important events)

Enumeration Date: 12/12/2005
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 OPITZ BLVD
WOODBRIDGE VA
22191-3311
US

IV. Provider business mailing address

8257 PURPLE LILAC CT
LORTON VA
22079-5641
US

V. Phone/Fax

Practice location:
  • Phone: 703-670-1357
  • Fax:
Mailing address:
  • Phone: 703-690-7845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024165617
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: