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Individual

SUSAN L GRANING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6441
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6441

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R827687
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00114407
MS
05
1650692
LA
01
P01761805
RAILROAD MEDICARE
MS
Enumeration date
12/19/2006
Last updated
02/09/2017
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