Most Relevant Information
Provider Data
| NPI Number: | 1003007329 |
| Provider Name: | SHIRLEY A JAUTZ CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 129615 |
Most Important Dates
| Enumeration Date: | 08/05/2007 |
| Last Updated: | 04/09/2014 |
Provider Practice Location
221 PHYSICIANS PARK
POPLAR BLUFF
MO
639013956
Practice Location Phone/Fax
| Phone: | 5737279080 |
| Fax: |
Provider Mailing Location
5983 US HIGHWAY 63
POMONA
MO
657899538
Provider Mailing Phone/Fax
| Phone: | 5736865550 |
| Fax: | 5736862139 |