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Individual

MS. BECKY B EVERETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2500 N STATE ST, PFS, JACKSON, MS 39216-4500
(601) 944-4619
Mailing address
301 GRAYLING BLVD, MADISON, MS 39110
(601) 918-5311

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
39359
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
R558931
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0123296
MS
Enumeration date
10/05/2006
Last updated
12/13/2010
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