Individual
MR. ANDREW FRANK FUNKHOUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 791-6133
Mailing address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 791-6133
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2015006766
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209012714
IL
Other
Enumeration date
03/12/2015
Last updated
07/29/2015
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