Individual
SHELBY L DENICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-2417
(217) 544-6464
Mailing address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-1000
(217) 544-6464
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2012001557
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209020424
IL
Other
Enumeration date
01/18/2012
Last updated
07/15/2024
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