Organization
PLASTIC CRNA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN H CRAWFORD (MANAGER)
(601) 484-2459
Entity
Organization
Contact information
Practice address
5002 HIGHWAY 39 N BLDG D, MERIDIAN, MS 39301-1078
(601) 484-2459
(601) 485-1698
Mailing address
5002 HIGHWAY 39 N BLDG D, MERIDIAN, MS 39301-1078
(601) 484-2459
(601) 485-1698
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG7434
RAILROAD MEDICARE
MS
Enumeration date
11/15/2006
Last updated
01/25/2011
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