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1104231422
JACKIE COOLEY
SPRINGFIELD, IL
NPI
1104231422
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: IL 209011614)
Enumeration Date
2014-06-25
Last Update Date
2014-06-25
Business Address
-- JACKIE COOLEY
800 E CARPENTER ST
SPRINGFIELD, IL 62702-5324
Phone number: 217-525-5643
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Mailing Address
-- JACKIE COOLEY
800 E CARPENTER ST
SPRINGFIELD, IL 62702-5324
Phone number: 217-525-5643
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