Individual provider · NPI-1

Jeannie Marie Hundley, CST/SA-C

Specialist/Technologist, Other, Surgical Assistant · Springfield, IL

NPI number1942552161

StatusActive

Last updated in NPPESOct 11, 2012

Details

NPI: 1942552161
Entity type: Individual (NPI-1)
Name: Mrs. Jeannie Marie Hundley
Credential: CST/SA-C
Sex: Female
Sole proprietor: Yes
Enumeration date: Oct 11, 2012
Last updated: Oct 11, 2012

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
246ZC0007X	Specialist/Technologist, Other, Surgical Assistant	–	–	Yes

Practice location

2921 Monvale Drive
Springfield, IL 62704

Phone 217-787-2700 · Fax 217-787-2715

Mailing address

2921 Monvale Drive
Springfield, IL 62704

Phone 217-787-2700 · Fax 217-787-2715

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