Provider Type Icon

HOLLY JACKSON CRNA NPI 1720575392


NPI Information

NPI: 1720575392
Provider Name: HOLLY JACKSON, CRNA
Classification: Nurse Anesthetist, Certified Registered - 367500000X
Entity Type: Individual
Address:
7601 SOUTHCREST PKWY
SOUTHAVEN, MS
ZIP 38671
Phone: (662) 772-4333
Get Directions

Holly Jackson, CRNA is a nurse anesthetist certified registered in Southaven, MS with 19 years of experience. The provider is (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. Holly Jackson, CRNA NPI is 1720575392. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7601 SOUTHCREST PKWY
SOUTHAVEN, MS
ZIP 38671-739
Phone: (662) 772-4333
Fax: (855) 999-1345

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Anesthesia for lens surgery (HCPCS:00142)
  • Anesthesia for procedure in upper abdomen including use of an endoscope (HCPCS:00790)

The enumeration date for this NPI number is 4/18/2018 and was last updated on 4/18/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1367500000XNurse Anesthetist, Certified Registered901371MISSISSIPPIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.