Individual provider · Type 1 NPI

James Maly Iv, CRNA

Student in an Organized Health Care Education/Training Program · Edwardsville, IL

NPI number 1992663652 Active

Practice location

1 Hairpin Drive
Edwardsville, IL 62026-0001

Call (618) 650-3228 Map

Mailing address

1 Lake Dr
Caseyville, IL 62232-2419

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X041564657 (IL)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1992663652

James Maly Iv, CRNA's National Provider Identifier is 1992663652, issued on Jan 12, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Edwardsville, IL. The record was last updated on Jan 12, 2026.