Individual
MR. GROVER SCOTT CRUISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
125 S 12TH AVE, HATTIESBURG, MS 39401-6106
(601) 310-4509
Mailing address
PO BOX 2295, ASHEVILLE, NC 28802-2295
(828) 398-5244
(828) 360-3080
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R847413
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121803
—
MS
05
—
2116461
—
LA
Enumeration date
04/19/2006
Last updated
10/03/2024
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