Provider Demographics
NPI:1821223785
Name:GLUNZ, JILL GUSTAFSON (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:GUSTAFSON
Last Name:GLUNZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:HOPE
Other - Last Name:GUSTAFSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:123 HAUSSAUER ROAD
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1425 PORTLAND AVENUE
Practice Address - Street 2:ROCHESTER GENERAL HOSPITAL
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3095
Practice Address - Country:US
Practice Address - Phone:585-922-4159
Practice Address - Fax:585-922-3731
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287266-1367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered