MEDICARE: CLAIRE E. JENKINS CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	26NR09930200	NJ
2	367500000X	Certified Registered Nurse Anesthetist	0024166767	VA

General Provider Information

NPI Number	:	1265478580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE E. JENKINS CRNA

Provider Business Mailing Address
First Line	:	7915 LAKE MANASSAS DR
Second Line	:	SUITE 302
City	:	GAINESVILLE
State	:	VA
Zip	:	20155-3258
Country	:	US
Telephone Number	:	571-248-0653
Fax Number	:	571-248-0658

Provider Business Practice Location Address
First Line	:	7915 LAKE MANASSAS DR
Second Line	:	SUITE 302
City	:	GAINESVILLE
State	:	VA
Zip	:	20155-3258
Country	:	US
Telephone Number	:	571-248-0653
Fax Number	:	571-248-0658

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	12/19/2016

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