Basic Information
| Provider Information | |||||||||
| NPI: | 1881016855 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARRIETA | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5730 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049155700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8884027256 | ||||||||
| FaxNumber: | 8889021099 | ||||||||
| Practice Location | |||||||||
| Address1: | 2930 N STANTON ST | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799022511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152714569 | ||||||||
| FaxNumber: | 9153510086 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2014 | ||||||||
| LastUpdateDate: | 11/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | AP125039 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.