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General NPI Number Information
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NPI Number | 1780711820
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Entity Type | Individual
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Provider Name | MARY ROHMAN CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 823 GRAND AVE
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City | YAZOO CITY
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State | MS
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Zip | 39194-3233
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Country | US
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Telephone | 662-751-8156
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Fax | 662-751-8226
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Provider Business Mailing Address
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Address Line | PO BOX 174
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City | YAZOO CITY
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State | MS
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Zip | 39194-0174
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Country | US
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Telephone | 662-746-2261
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Fax | 662-751-8226
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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 | R555398
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License Number State | MS
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