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NPI Code Detail

MEDICARE: MRS. YU JIANG CRNA

MEDICARE: MRS. YU JIANG 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
1163W00000XRegistered NurseRN508249TX
2363L00000XNurse PractitionerAP103737TX
3367500000XCertified Registered Nurse Anesthetist508249TX
4367500000XCertified Registered Nurse AnesthetistAP103737TX
5367500000XCertified Registered Nurse Anesthetist41430TX

General Provider Information

NPI Number : 1548250145
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. YU JIANG CRNA
Provider Business Mailing Address
First Line : PO BOX 22926
Second Line :
City : JACKSON
State : MS
Zip : 39225-2926
Country : US
Telephone Number : 713-400-2990
Fax Number : 713-400-2993
Provider Business Practice Location Address
First Line : 1635 NORTH LOOP W
Second Line :
City : HOUSTON
State : TX
Zip : 77008-1532
Country : US
Telephone Number : 713-400-2990
Fax Number : 713-400-2993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2005
Last Update Date : 09/21/2018

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