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General NPI Number Information
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NPI Number | 1174674063
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Entity Type | Individual
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Provider Name | JANA MARLENE OTT CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 300 UNIVERSITY BLVD
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City | ROUND ROCK
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State | TX
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Zip | 78665-1032
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Country | US
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Telephone | 512-509-0100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 844658
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City | DALLAS
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State | TX
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Zip | 75284-4658
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Country | US
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Telephone | 800-994-0371
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Fax | 254-215-9722
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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 | 11409
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP100837
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 113789
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License Number State | WV
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