Individual
JASON J SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1225 N STATE ST, JACKSON, MS 39202-2064
(601) 968-1000
(601) 944-9780
Mailing address
1012 AUBURN DR, JACKSON, MS 39211-4226
(769) 524-4686
(601) 944-9780
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R872238
MS
Other
Enumeration date
08/05/2013
Last updated
08/05/2013
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