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Individual

MRS. JENNY KUNVARJI SHAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA APN

Contact information

Practice address
802 W TRAILCREEK DR, COSMETIC SURGERY CARE, PEORIA, IL 61614-1862
(309) 692-3630
(309) 692-3790
Mailing address
802 W TRAILCREEK DR, COSMETIC SURGERY CARE, PEORIA, IL 61614-1862
(309) 692-3630
(309) 692-3790

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
IL

Other

Enumeration date
02/19/2008
Last updated
02/19/2008
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