Individual
VINCENT P CAGUNGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-4644
(217) 258-4006
Mailing address
912 OAKCREST DR APT F, CHARLESTON, IL 61920-1780
(858) 722-3728
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041.498060
IL
Other
Enumeration date
08/05/2020
Last updated
08/05/2020
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