Individual
STEPHEN HORNADAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
971 LAKELAND DR, SUITE 202, JACKSON, MS 39216-4643
(601) 362-1990
Mailing address
971 LAKELAND DR, SUITE 202, JACKSON, MS 39216-4643
(601) 362-1990
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R852030
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126846
—
MS
05
—
8052886
—
NC
Enumeration date
06/10/2006
Last updated
11/13/2007
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