Individual
MRS. ELISE REEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
215 MARION AVE, MCCOMB, MS 39648-2705
(601) 249-5500
Mailing address
215 MARION AVE, MCCOMB, MS 39648-2705
(601) 249-1802
(601) 249-1709
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R883639
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07829507
—
MS
01
—
AP08334
LA LICENSE
LA
Enumeration date
07/07/2015
Last updated
11/15/2023
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