Individual
JENNIFER MARIE TRUESDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18646 GOLFVIEW AVE, HOMEWOOD, IL 60430-3608
(708) 337-0558
Mailing address
18646 GOLFVIEW AVE, HOMEWOOD, IL 60430-3608
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041351556
IL
163W00000X
Registered Nurse
28200184A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
088037
IN
Other
Enumeration date
03/26/2012
Last updated
04/11/2012
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