Individual
JESSICA MORTOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP CRNA
Contact information
Practice address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5683
(928) 855-8185
Mailing address
537 NORWOOD ST, REDLANDS, CA 92373-5888
(805) 550-5506
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
152003
AZ
Other
Enumeration date
01/08/2025
Last updated
01/08/2025
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