Individual
JEREMIAH WESLEY DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
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) 261-3606
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN187112
GA
163W00000X
Registered Nurse
RN9215601
FL
367500000X
Certified Registered Nurse Anesthetist
17723
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
863775
MS
367500000X
Certified Registered Nurse Anesthetist
901433
MS
367500000X
Certified Registered Nurse Anesthetist
RN187112
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02323776
—
MS
01
—
1952395097
NORTH GEORGIA MEDICAL CENTER NPI
GA
01
—
58-1896463
NORTH GEORGIA MEDICAL CENTER, TAX ID
GA
01
—
RN187112
RN LICENSE
GA
Enumeration date
01/05/2007
Last updated
04/01/2026
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