Basic Information
| Provider Information | |||||||||
| NPI: | 1972564797 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SILVEY | ||||||||
| FirstName: | JILL | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 KATHERINE DR STE G | ||||||||
| Address2: | |||||||||
| City: | FLOWOOD | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392328857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019339521 | ||||||||
| FaxNumber: | 6019339525 | ||||||||
| Practice Location | |||||||||
| Address1: | 1030 RIVER OAKS DRIVE | ||||||||
| Address2: | ANESTHESIA | ||||||||
| City: | FLOWOOD | ||||||||
| State: | MS | ||||||||
| PostalCode: | 39232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019321030 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 01/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | ARNP2030562 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 901527 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 000902789A | 05 | GA | MEDICAID | 3036901-00 | 05 | FL | MEDICAID | 000902789B | 05 | GA | MEDICAID |