| NPI | 1548696925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BLAKE BENEFIELD Manager 228-860-0820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R874062) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R863937) |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R867945) | |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2016-10-11 |