Provider Demographics
NPI:1871519793
Name:ADAMS, JESSICA MCQUISTON (CRNA)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MCQUISTON
Last Name:ADAMS
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:PO BOX 122431
Mailing Address - Street 2:DEPT 2431
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-2431
Mailing Address - Country:US
Mailing Address - Phone:337-480-8900
Mailing Address - Fax:337-480-8901
Practice Address - Street 1:1000 WALTERS ST
Practice Address - Street 2:LSU W O MOSS REGIONAL MEDICAL CENTER
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-4699
Practice Address - Country:US
Practice Address - Phone:337-475-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2018-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAAP04473367500000X
LARN100409367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered