Individual
JACQUELINE C QUALLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1104 RED OAK AVE, DURHAM, NC 27707-4924
(919) 806-9202
Mailing address
1104 RED OAK AVE, DURHAM, NC 27707-4924
(919) 806-9202
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
343495L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
343495
PA
Other
Enumeration date
02/16/2007
Last updated
09/11/2025
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