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Individual

ASHLEY E JUHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(618) 549-0721
(618) 529-0449
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209010280
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
214881
MULTISPECIALTY GROUP PTAN
IL
Enumeration date
03/07/2013
Last updated
11/25/2020
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