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Individual

ERIC ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62702-5324
(217) 525-5643
Mailing address
800 E CARPENTER ST, SPRINGFIELD, IL 62702-5324

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2014013826
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209011621
IL

Other

Enumeration date
06/26/2014
Last updated
12/28/2021
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