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General NPI Number Information
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NPI Number | 1982651139
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Entity Type | Individual
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Provider Name | JUDITH A. JARVIS CRNA
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Gender | Female
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 5530 WISCONSIN AVE. SUITE 1620
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City | CHEVY CHASE
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State | MD
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Zip | 20815-4404
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Country | US
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Telephone | 301-718-9800
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Fax | 301-986-1672
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Provider Business Mailing Address
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Address Line | 13523 BARRETT PARKWAY DRIVE SUITE 104
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City | BALLWIN
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State | MO
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Zip | 63021
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Country | US
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Telephone | 636-549-2380
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Fax | 314-569-5974
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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 | R085325
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License Number State | MD
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