Individual
MR. JERRY EDWARD GLATTFELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 BODIN CIR, 60 TH MSGS/SGCSA, TRAVIS AFB, CA 94535-1804
(707) 423-5370
Mailing address
1131 PARK LN, SUISUN CITY, CA 94585-2878
(707) 428-4272
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041-232449
IL
367500000X
Certified Registered Nurse Anesthetist
209-003657 APN LICEN
IL
Other
Enumeration date
11/11/2005
Last updated
09/01/2010
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