Individual
MR. JEFFREY COLENCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 458-8899
Mailing address
PO BOX 220, ROLLA, MO 65402-0220
(573) 458-8899
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
121078
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
915685408
—
MO
Enumeration date
01/24/2006
Last updated
11/02/2021
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