Healthcare Provider Details

I. General information

NPI: 1528733631
Provider Name (Legal Business Name): MORGAN A GRONES CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 ALCORN DR
CORINTH MS
38834-9321
US

IV. Provider business mailing address

3340 PLAYERS CLUB PKWY STE 350
MEMPHIS TN
38125-8949
US

V. Phone/Fax

Practice location:
  • Phone: 662-293-1000
  • Fax: 844-752-2163
Mailing address:
  • Phone: 901-844-1590
  • Fax: 844-752-2163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number33327
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number901724
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: