Provider Demographics
NPI:1912411612
Name:MURATA, JESSICA CHAMBERS (CRNA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:CHAMBERS
Last Name:MURATA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:COURTNEY
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2503 BUCKELEW DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-1910
Mailing Address - Country:US
Mailing Address - Phone:703-731-7769
Mailing Address - Fax:
Practice Address - Street 1:2503 BUCKELEW DR
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-1910
Practice Address - Country:US
Practice Address - Phone:703-731-7769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-17
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001240624163WC0200X
VA0024175770367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care MedicineGroup - Single Specialty