Provider Demographics
NPI:1578548665
Name:WRIGHT, JO ANN ELIZABETH (CRNA)
Entity Type:Individual
Prefix:MS
First Name:JO ANN
Middle Name:ELIZABETH
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:JO ANN
Other - Middle Name:ELIZABETH
Other - Last Name:SERSLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:8257 PURPLE LILAC CT
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-5641
Mailing Address - Country:US
Mailing Address - Phone:703-690-7845
Mailing Address - Fax:
Practice Address - Street 1:2300 OPITZ BLVD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3311
Practice Address - Country:US
Practice Address - Phone:703-670-1357
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165617367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered