Individual
MR. NICK A DENIAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1220 JEFFERSON ST, LAUREL, MS 39440-4355
(601) 399-6167
(601) 399-6281
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 399-6167
(601) 399-6281
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R793528
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00112356
—
MS
Enumeration date
06/07/2006
Last updated
02/11/2014
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