Individual
MR. CHARLES WAYNE CHANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3109 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-4361
(228) 818-1111
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R520705
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430068781
RAILROAD MEDICARE
—
01
—
640942692
BLUE CROSS OF MS
—
05
—
CWC00015826
—
MS
Enumeration date
02/23/2007
Last updated
01/07/2011
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