Individual
MR. KENNON DANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3301 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-4318
(228) 818-1111
Mailing address
P O BOX 3488, DEPT 05-113, TUPELO, MS 38803-3488
(678) 553-8150
(678) 553-8152
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R726397
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430071927
RAILROAD MEDICARE
—
01
—
640942692
BLUE CROSS OF MS
—
05
—
KD00016173
—
MS
Enumeration date
02/23/2007
Last updated
09/01/2017
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