LISA MOMENT

CHAMPAIGN, IL
NPI1205250859
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209.011117)
Enumeration Date2014-02-18
Last Update Date2014-02-28
Business Address
-- LISA MOMENT
1701 CURTIS RD
CHAMPAIGN, IL 61822-9678
Phone number: 217-365-6201
Mailing Address
-- LISA MOMENT
611 W PARK ST BWPC
URBANA, IL 61801-2500
Phone number: 217-383-6941
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