Healthcare Provider Details

I. General information

NPI: 1972564797
Provider Name (Legal Business Name): JILL P SILVEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 01/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 RIVER OAKS DRIVE ANESTHESIA
FLOWOOD MS
39232
US

IV. Provider business mailing address

105 KATHERINE DR STE G
FLOWOOD MS
39232-8857
US

V. Phone/Fax

Practice location:
  • Phone: 601-932-1030
  • Fax:
Mailing address:
  • Phone: 601-933-9521
  • Fax: 601-933-9525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP2030562
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number901527
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: