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Individual

JOSHUA BLAKE TRAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DNP

Contact information

Practice address
215 MARION AVE, MCCOMB, MS 39648-2705
(601) 249-5500
Mailing address
215 MARION AVE, MCCOMB, MS 39648-2705
(601) 249-5500

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
904178
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
901853
MS

Other

Enumeration date
06/24/2021
Last updated
05/31/2023
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