Individual
LAVINIA D JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 JACKSON ST, VICKSBURG, MS 39183-2519
(601) 420-5810
(604) 420-5811
Mailing address
3531 LAKELAND DR STE 1060, FLOWOOD, MS 39232-8016
(601) 420-5810
(601) 420-5811
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
906111
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
906111
MS
367500000X
Certified Registered Nurse Anesthetist
R857248
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126795
—
MS
01
—
P00695430
MEDICARE RAILROAD
MS
Enumeration date
06/09/2006
Last updated
03/27/2024
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