Burrell, Mark C.

Burrell, Mark C. is an individual health care provider with primary practice located at 1850 Chadwick Dr , Jackson MS 39204-3404. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Burrell, Mark C. can be contacted via phone (601) 376-1848.

Contact Information

Primary practice address
1850 Chadwick Dr Jackson MS 39204-3404
Phone: (601) 376-1848
Fax: (601) 376-1894
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R853573 Mississippi

Profile Details

NPI number 1730161779
LBN Legal business name Burrell, Mark C.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Aug 13th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730161779 NPPES
Mississippi MEDICAID 03323222
Mississippi Other P00142072

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