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1073158119
STACEY TEBBE
MATTOON, IL
NPI
1073158119
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209020253)
Enumeration Date
2019-11-13
Last Update Date
2020-10-29
Business Address
Mrs. STACEY TEBBE
101 COLES CENTRE DR
MATTOON, IL 61938-9314
Phone number: 217-234-5110
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Mailing Address
Mrs. STACEY TEBBE
101 COLES CENTRE DR
MATTOON, IL 61938-9314
Phone number: 217-234-5110
Copy
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