KELLY J SLADE

DECATUR, IL
NPI1306240767
Former NameKELLY J CRISPIN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IL  209.011917)
Enumeration Date2014-10-14
Last Update Date2019-11-01
Business Address
KELLY J SLADE N.P.
176 W MOUND RD
DECATUR, IL 62526-1964
Phone number: 217-391-8730
Mailing Address
KELLY J SLADE N.P.
176 W MOUND RD
DECATUR, IL 62526-1964
Phone number: 217-391-8730
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