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1164951802
JEANETTE LONG
ELDORADO, IL
NPI
1164951802
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: IL 043072196)
Enumeration Date
2017-06-07
Last Update Date
2017-06-07
Business Address
Ms. JEANETTE LONG LPN
70 ALEXANDER ST
ELDORADO, IL 62930
Phone number: 618-841-0074
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Mailing Address
Ms. JEANETTE LONG LPN
PO BOX 218
ELIZABETHTWON, IL 62931
Phone number:
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