Sistrunk, Mareen Ann

Sistrunk, Mareen Ann is an individual health care provider with primary practice located at 415 S 28Th Ave , Hattiesburg MS 39401-7246. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Sistrunk, Mareen Ann can be contacted via phone (601) 261-3606.

Contact Information

Primary practice address
415 S 28Th Ave Hattiesburg MS 39401-7246
Phone: (601) 261-3606
Fax: (601) 579-5383
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP9272993 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 901383 Mississippi

Profile Details

NPI number 1528309887
LBN Legal business name Sistrunk, Mareen Ann
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 12th, 2013
Last updated Jul 30th, 2020 - about 6 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 1528309887 NPPES
Mississippi MEDICAID 00638261

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