Healthcare Provider Details

I. General information

NPI: 1720945892
Provider Name (Legal Business Name): ANA ECATERINA PRIMEAUX DNP, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 GRAND OAK DR
MERIDIAN MS
39305-9190
US

IV. Provider business mailing address

481 GRAND OAK DR
MERIDIAN MS
39305-9190
US

V. Phone/Fax

Practice location:
  • Phone: 337-371-1608
  • Fax:
Mailing address:
  • Phone: 337-371-1608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberPRIM-5CDGGT
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: