Individual
JON ELWIN CLEGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
605 S MAIN AVE, SIOUX CENTER, IA 51250-1347
(712) 722-1271
Mailing address
605 S MAIN AVE, SIOUX CENTER, IA 51250-1347
(712) 722-1271
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D-103958
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20369
IOWA BLUE CROSS NUMBER
IA
Enumeration date
02/16/2007
Last updated
07/08/2007
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