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General NPI Number Information
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NPI Number | 1477154607
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Entity Type | Individual
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Provider Name | JESSICA NICOLE BRICKERS CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 1755 N MECKLENBURG AVE
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City | SOUTH HILL
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State | VA
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Zip | 23970-4080
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Country | US
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Telephone | 804-828-2207
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Fax | 804-828-8300
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Provider Business Mailing Address
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Address Line | PO BOX 780125
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City | PHILADELPHIA
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State | PA
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Zip | 19178-0125
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Country | US
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Telephone | 804-922-4844
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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 | 6544
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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 | 134347
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License Number State | NC
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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 | 0024192591
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License Number State | VA
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