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1134194160
LISA SMITH
DECATUR, IL
NPI
1134194160
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: IL 209.004906)
Enumeration Date
2006-02-22
Last Update Date
2014-03-13
Business Address
Mrs. LISA SMITH PNP
2905 N MAIN ST
DECATUR, IL 62526-4274
Phone number: 217-877-9117
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Mailing Address
Mrs. LISA SMITH PNP
2905 N MAIN ST
DECATUR, IL 62526-4274
Phone number: 217-877-9117
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