Individual
JENNY SUE MAGRUDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP-A, CRNA
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 606-4522
Mailing address
PO BOX 515, RUSK, TX 75785-0515
(713) 540-2391
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
947461
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
1150804
TX
Other
Enumeration date
01/08/2024
Last updated
01/29/2024
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