Individual
JANA MARLENE OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
300 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1032
(512) 509-0100
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
(254) 215-9722
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
113789
WV
367500000X
Certified Registered Nurse Anesthetist
11409
CT
367500000X
Certified Registered Nurse Anesthetist
Primary
AP100837
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109955805
—
TX
01
—
430027414
RAILROAD MEDICARE
—
01
—
88641C
TX-BLUE SHIELD
—
Enumeration date
01/16/2007
Last updated
06/17/2025
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