Healthcare Provider Details

I. General information

NPI: 1619089810
Provider Name (Legal Business Name): DONNA FINK MORGAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 LAKELAND DR
FLOWOOD MS
39232-9513
US

IV. Provider business mailing address

2510 LAKELAND DR
FLOWOOD MS
39232-9513
US

V. Phone/Fax

Practice location:
  • Phone: 601-355-1234
  • Fax: 601-352-4882
Mailing address:
  • Phone: 601-355-1234
  • Fax: 601-326-3559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR749981
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: