Healthcare Provider Details

I. General information

NPI: 1285751966
Provider Name (Legal Business Name): JEAN M RAMSEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 POPLAR STRET
MURRAY KS
42071
US

IV. Provider business mailing address

CR 262 BOX 155B
IUKA MS
38852
US

V. Phone/Fax

Practice location:
  • Phone: 270-762-1330
  • Fax:
Mailing address:
  • Phone: 662-423-3585
  • Fax: 662-423-3585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1109158
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberC01240-CRNA
License Number StateAR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: