Individual
MS. JACQUELINE LEE WHARTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8260 ATLEE ROAD, MECHANICSVILLE, VA 23116-1844
(804) 288-4921
(804) 282-9921
Mailing address
804 SCOTT NIXON MEMORIAL DRIVE, AUGUSTA, GA 30907-2464
(800) 394-4445
(706) 650-1034
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024058884
VA
367500000X
Certified Registered Nurse Anesthetist
029576
NC
367500000X
Certified Registered Nurse Anesthetist
114808
NC
Other
Enumeration date
01/08/2007
Last updated
11/13/2012
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