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General NPI Number Information
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NPI Number | 1477377190
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Entity Type | Individual
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Provider Name | JESSICA CHING LAI CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/09/2024
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 2301 ERWIN RD
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City | DURHAM
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State | NC
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Zip | 27705-4699
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Country | US
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Telephone | 919-684-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 1598 BRIARVISTA WAY NE
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City | ATLANTA
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State | GA
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Zip | 30329-3638
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Country | US
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Telephone | 919-685-6821
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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 | 156429
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 304553
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License Number State | NC
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