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General NPI Number Information
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NPI Number | 1073080602
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Entity Type | Individual
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Provider Name | JINGZHE GAO DNP-CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/01/2018
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1775 THOMPSON RD
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City | COOS BAY
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State | OR
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Zip | 97420-2198
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Country | US
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Telephone | 541-269-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 COLD SPRING RD # G421
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City | INDIANAPOLIS
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State | IN
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Zip | 46222-1960
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Country | US
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Telephone | 315-717-7646
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 156555
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License Number State | OR
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