Facts
- Status
- A
- Credential
- APN, FNP
- Type
- Individual
- Enumeration date
- 2012-10-18
- Last updated
- 2020-10-13
Specialties
Licenses
- License IL
- 209002921
Location
- Practice location
- 535 PARK AVE E
- City
- PRINCETON IL
- Postal code
- 613562537
- Phone
- 815-875-4531
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.