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Individual

JESSICA DIAMOND DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2500 N STATE ST, DEPARTMENT OF ANESTHESIOLOGY, JACKSON, MS 39216-4500
(601) 754-7829
Mailing address
4002 KINGS HWY, JACKSON, MS 39216-3329
(601) 754-7829

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R885722
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04707818
MS
05
179480
AL
01
P01629817
RAILROAD MEDICARE
MS
Enumeration date
12/04/2014
Last updated
02/05/2024
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