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1386171809
CASEY AT DIVELY
TAYLORVILLE, IL
NPI
1386171809
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209015986041408044)
Enumeration Date
2017-05-15
Last Update Date
2025-01-13
Business Address
CASEY AT DIVELY NP-C
1304 BURNETT DR
TAYLORVILLE, IL 62568-9519
Phone number: 217-321-9310
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Mailing Address
CASEY AT DIVELY NP-C
1304 BURNETT DR
TAYLORVILLE, IL 62568-9519
Phone number: 217-321-9310
Copy
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