DEATRICE LAVONNA BLACK

JOLIET, IL
NPI1215448352
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy164X00000X Licensed Vocational Nurse
(Licence: IL  043117036)
Additional Taxonomies164W00000X Licensed Practical Nurse
(Licence: IL  043117036)
Enumeration Date2017-10-16
Last Update Date2017-10-16
Business Address
DEATRICE LAVONNA BLACK LPN
503 BELLARMINE DR E APT 7
JOLIET, IL 60436-1838
Phone number: 815-456-9757
Mailing Address
DEATRICE LAVONNA BLACK LPN
503 BELLARMINE DR E APT 7
JOLIET, IL 60436-1838
Phone number: 815-456-9757