Individual
MERIA EISENBRAUN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA, MSN
Contact information
Practice address
500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
(757) 594-2000
Mailing address
3998 FAIR RIDGE DR, STE 300, FAIRFAX, VA 22033-2907
(703) 766-9737
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
513064
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952724601
—
VA
Enumeration date
01/31/2014
Last updated
03/19/2015
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