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Individual

SHELLEY JELINEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 668-1853
(731) 664-7731
Mailing address
49 BENT CREEK LN, JACKSON, TN 38305-2172
(731) 668-1853
(731) 664-7731

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
148114
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
14355
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14355
APN LICENSE
TN
01
148114
RN LICENSE
TN
Enumeration date
06/24/2009
Last updated
01/18/2011
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