Individual
EMILY SUMRALL CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R872306
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01588596
—
MS
01
—
P01500390
RAILROAD MEDICARE
MS
Enumeration date
01/04/2010
Last updated
10/06/2015
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