Healthcare Provider Details

I. General information

NPI: 1437536380
Provider Name (Legal Business Name): NURSE ANESTHESIA SERVICES OF MERIDIAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5002 HIGHWAY 39 N BUILDING D
MERIDIAN MS
39301-1078
US

IV. Provider business mailing address

PO BOX 1070
MERIDIAN MS
39302-1070
US

V. Phone/Fax

Practice location:
  • Phone: 601-696-8000
  • Fax:
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: MR. JAMES P HAYS III
Title or Position: ADMINISTRATOR
Credential: CRNA
Phone: 601-513-0869