Healthcare Provider Details

I. General information

NPI: 1427667724
Provider Name (Legal Business Name): SWEET DREAMS ANESTHESIA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2020
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 14TH ST
MERIDIAN MS
39301-4458
US

IV. Provider business mailing address

PO BOX 1413
MERIDIAN MS
39302-1413
US

V. Phone/Fax

Practice location:
  • Phone: 601-482-9224
  • Fax: 601-482-9223
Mailing address:
  • Phone: 601-485-6325
  • Fax: 601-485-3061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KIMBERLY BUSBEA
Title or Position: OWNER
Credential: CRNA
Phone: 601-482-9224