Individual
MR. HASKELL J. NUTGRASS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
911 STACEY BURK DR, FLORA, IL 62839-3241
(618) 662-1638
Mailing address
117 E 3RD ST, FLORA, IL 62839-2036
(618) 662-2397
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
IL
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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