Individual
CHARLES MUSSELWHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3882 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-5803
(228) 872-6290
(228) 762-0065
Mailing address
PO BOX 1684, PASCAGOULA, MS 39568-1684
(228) 762-9080
(228) 762-0065
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R741121
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009994055
ALACAID
MS
05
—
0115359
—
MS
01
—
169045200
USDOL
—
01
—
430064344
MEDICARE RAILROAD
MS
01
—
587210340C
AHS STATE
MS
Enumeration date
08/30/2006
Last updated
05/20/2008
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