Individual
THERESA ANN DAVIS
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
113 TIMBER DRIVE, MADISON, MS 39110
(601) 270-7770
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R874019
MS
Other
Enumeration date
01/31/2011
Last updated
07/30/2015
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