Individual
MS. OLGA LEONIDIVNA JUNKULIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CRNA
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-3450
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704264252
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
21794
SC
367500000X
Certified Registered Nurse Anesthetist
4704264252
MI
Other
Enumeration date
10/23/2013
Last updated
12/16/2019
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