Individual
MRS. CHRISTINA RAYBURN FORTENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
215 MARION AVE, MCCOMB, MS 39648-2705
(601) 249-5500
Mailing address
329 WEST CHIPPEWA STREET, BROOKHAVEN, MS 39601
(601) 823-6778
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R854811
MS
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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