Individual
BLAKELEY WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2500 N STATE ST, PFS, JACKSON, MS 39216-4500
(601) 984-4619
(601) 984-4657
Mailing address
105 S GLEN PL, MADISON, MS 39110-6904
(601) 613-6609
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R858198
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09136271
—
MS
01
—
P00793035
RAILROAD MEDICARE
MS
Enumeration date
05/12/2006
Last updated
03/04/2026
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