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General NPI Number Information
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NPI Number | 1457606675
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Entity Type | Individual
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Provider Name | JESSICA LEIGH METZLER CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/14/2012
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 700 W MEETING ST
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City | LANCASTER
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State | SC
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Zip | 29720-2328
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Country | US
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Telephone | 704-779-8181
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Fax |
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Provider Business Mailing Address
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Address Line | 1623 HAWKSTONE DR
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City | WAXHAW
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State | NC
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Zip | 28173-7447
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Country | US
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Telephone | 704-779-8181
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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 | 091161
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License Number State | NC
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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 | 24702
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 240188
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License Number State | NC
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