| NPI | 1265154900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTINE BEAMAN Owner/Nurse Practitioner 815-762-0244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2023-09-04 |