Individual
MRS. LORI CRYSTAL WOULLARD-BRELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-3606
(601) 579-5383
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5463
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN9456859
FL
367500000X
Certified Registered Nurse Anesthetist
R859468
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07527007
—
MS
01
—
3476675
UNITED HEALTHCARE
MS
01
—
6655503
CIGNA
MS
01
—
9369843
AETNA
MS
Enumeration date
07/07/2011
Last updated
02/12/2025
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