Individual
SHAUNA L GLENN
Active
Individual
SHAUNA L GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041347092
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209008446
IL
Other
Enumeration date
10/25/2010
Last updated
07/22/2011
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