Individual
JENEE ELIZABETH BEUTERBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1235 E CHEROKEE ST, ANESTHESIA, SPRINGFIELD, MO 65804-2203
(417) 820-2829
(417) 820-8852
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2010024478
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183614001
—
AR
05
—
1912210493
—
MO
01
—
431560263
TRICARE WEST
—
01
—
P00852005
RAILROAD MEDICARE GROUP CB9013
—
Enumeration date
07/26/2010
Last updated
05/20/2011
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