Individual
MS. JANA S LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
(901) 448-5893
(901) 448-5540
Mailing address
877 JEFFERSON AVE, ATTN: PROVIDER ENROLLMENT, MEMPHIS, TN 38103-2807
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
10662
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3607248
—
TN
Enumeration date
05/01/2006
Last updated
05/18/2016
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