Individual
CIERRA JANIECE JETHRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 HAIRPIN DRIVE, EDWARDSVILLE, IL 62026-0001
(618) 650-3956
Mailing address
1 HAIRPIN DRIVE, EDWARDSVILLE, IL 62026-0001
(618) 650-3956
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2025023180
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/21/2023
Last updated
06/17/2025
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