Provider Demographics
NPI:1699031781
Name:ERJAVAC, JESSICA ASHLEY (CRNA)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:ASHLEY
Last Name:ERJAVAC
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ASHLEY
Other - Last Name:KETCHUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:200 LOTHROP ST
Mailing Address - Street 2:SUITE 9055 FORBES TOWER
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-647-3087
Mailing Address - Fax:412-647-4486
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:SUITE 9055 FORBES TOWER
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-647-3087
Practice Address - Fax:412-647-4486
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN569725367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered