Individual
AUDREY DONNA GHATAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
300 3RD AVE SE, MAGEE, MS 39111-3665
(601) 849-7173
(601) 849-7353
Mailing address
PO BOX 669, MOUNT OLIVE, MS 39119-0669
(601) 466-3601
(601) 797-9993
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R125620
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00110086
—
MS
Enumeration date
09/12/2006
Last updated
07/08/2007
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