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Individual

EMMA PHUONG TO

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) 984-5952
Mailing address
105 KATHERINE DR STE G, FLOWOOD, MS 39232-8857
(601) 933-9521
(601) 933-9525

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
891838
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
901540
MS

Other

Enumeration date
11/07/2018
Last updated
04/16/2026
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