Individual
JESSICA JONES GOTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 CHERRY ST, BLUEFIELD, WV 24701-3306
(304) 327-1656
Mailing address
1563 STONEY BATTERY RD, MARION, VA 24354-6887
(276) 685-2751
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0001206731
VA
Other
Enumeration date
01/30/2013
Last updated
01/30/2013
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