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1265137814
MELINDA SUE LOGAN
DECATUR, IL
NPI
1265137814
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209.026952)
Enumeration Date
2023-04-03
Last Update Date
2023-04-03
Business Address
Mrs. MELINDA SUE LOGAN FNP
1110 ARBOR DR STE A
DECATUR, IL 62526-9289
Phone number: 217-413-8331
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Mailing Address
Mrs. MELINDA SUE LOGAN FNP
1505 W MACON ST
DECATUR, IL 62522-2753
Phone number: 217-454-6267
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