Organization
NURSE ANESTHESIA PROVIDERS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN W SEALE CRNA (OWNER)
(601) 260-2350
Entity
Organization
Contact information
Practice address
3353 N GLOSTER ST, TUPELO, MS 38804-9735
(662) 407-0334
(662) 407-0335
Mailing address
PO BOX 85, BRANDON, MS 39043-0085
(601) 260-2350
(601) 706-4175
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R686891
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08508830
—
MS
01
—
1275512410
INDIVIDUAL NPI
MS
01
—
426332234B
BCBS OF MS
MS
01
—
P00367222
RR MEDICARE
MS
Enumeration date
05/15/2007
Last updated
10/03/2013
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