Organization
HOLDER ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNEYE HOLDER CRNA (OWNER)
(662) 550-4299
Entity
Organization
Contact information
Practice address
2311 JACKSON AVE W, SUITE 302, OXFORD, MS 38655-5750
(662) 612-0063
(662) 580-4324
Mailing address
PO BOX 1596, OXFORD, MS 38655-1596
(662) 550-4299
(662) 580-4324
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
03/14/2016
Last updated
03/21/2016
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