Individual
DR. JASON ALLAN PATACSIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 450-4785
(910) 450-4790
Mailing address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 450-4785
(910) 450-4790
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
041-302032
IL
367500000X
Certified Registered Nurse Anesthetist
209-008050
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
257568
NC
367500000X
Certified Registered Nurse Anesthetist
9291172
FL
Other
Enumeration date
02/17/2009
Last updated
03/04/2025
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