Individual
MRS. SHANIKA H GUNDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2345 DOUGHERTY FERRY RD, ST LOUIS, MO 63122
(314) 821-5850
Mailing address
13523 BARRETT PARKWAY DR, SUITE 210, BALLWIN, MO 63021-3802
(314) 775-2816
(314) 775-2821
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2001003222
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
914462007
—
MO
Enumeration date
05/21/2007
Last updated
05/14/2009
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