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General NPI Number Information
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NPI Number | 1861449969
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Entity Type | Individual
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Provider Name | JENNIFER CILIA CRNA
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Gender | Female
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 601 PARK ST
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City | HONESDALE
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State | PA
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Zip | 18431-1498
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Country | US
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Telephone | 570-253-8112
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Fax |
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Provider Business Mailing Address
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Address Line | 3998 FAIR RIDGE DR SUITE 300
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City | FAIRFAX
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State | VA
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Zip | 22033-2921
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Country | US
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Telephone | 703-295-9360
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Fax | 703-766-9725
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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 | RN518149L
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License Number State | PA
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