Provider Demographics
NPI:1578974770
Name:WENTHE, JAEMEE (CRNA)
Entity Type:Individual
Prefix:
First Name:JAEMEE
Middle Name:
Last Name:WENTHE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JAEMEE
Other - Middle Name:
Other - Last Name:MONAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:6761 E OPATAS ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3336
Mailing Address - Country:US
Mailing Address - Phone:702-480-5007
Mailing Address - Fax:
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3307
Practice Address - Country:US
Practice Address - Phone:703-776-3138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171409367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered