JERRY LEE STUFFLE

CROWN POINT, IN
NPI1922257211
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: IN  28121816A)
Additional Taxonomies367500000X Nurse Anesthetist, Certified Registered
(Licence: IL  041.313724)
Enumeration Date2008-09-11
Last Update Date2008-09-11
Business Address
Mr. JERRY LEE STUFFLE CRNA
8673 CALHOUN PL
CROWN POINT, IN 46307-7713
Phone number: 219-365-7954
Mailing Address
Mr. JERRY LEE STUFFLE CRNA
8673 CALHOUN PL
CROWN POINT, IN 46307-7713
Phone number: 219-365-7954