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General NPI Number Information
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NPI Number | 1598875767
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Entity Type | Individual
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Provider Name | CHARLES MUSSELWHITE CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 3882 BIENVILLE BLVD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-5803
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Country | US
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Telephone | 228-872-6290
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Fax | 228-762-0065
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Provider Business Mailing Address
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Address Line | PO BOX 1684
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City | PASCAGOULA
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State | MS
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Zip | 39568-1684
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Country | US
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Telephone | 228-762-9080
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Fax | 228-762-0065
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R741121
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License Number State | MS
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