Healthcare Provider Details

I. General information

NPI: 1558786673
Provider Name (Legal Business Name): KENDALL SANDERS MCMURPHY C.R.N.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2014
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 DENNY AVE
PASCAGOULA MS
39581
US

IV. Provider business mailing address

PO BOX 3488
TUPELO MS
38803-3488
US

V. Phone/Fax

Practice location:
  • Phone: 228-818-1111
  • Fax: 844-876-0873
Mailing address:
  • Phone: 317-614-9863
  • Fax: 844-876-0873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN257526
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP07626
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number901559
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: