Provider Demographics
NPI:1407522998
Name:SPRATLIN, JENNIFER NEYMAN (CRNA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:NEYMAN
Last Name:SPRATLIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1506
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39760-1506
Mailing Address - Country:US
Mailing Address - Phone:662-615-2504
Mailing Address - Fax:662-615-2554
Practice Address - Street 1:400 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2163
Practice Address - Country:US
Practice Address - Phone:662-615-2504
Practice Address - Fax:662-615-2554
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901926367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered