Individual
BEN J SHIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2124 14TH ST, MERIDIAN, MS 39301-4040
(601) 553-6000
(601) 553-6115
Mailing address
8973 HIGHWAY 495, MERIDIAN, MS 39305-9288
(601) 737-4910
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R858466
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009949395
—
AL
05
—
05088759
—
MS
01
—
730-14502
BLUE CROSS OF AL
AL
Enumeration date
08/13/2006
Last updated
07/08/2007
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