CASEY AT DIVELY

SPRINGFIELD, IL
NPI1386171809
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209015986041408044)
Enumeration Date2017-05-15
Last Update Date2019-10-22
Business Address
CASEY AT DIVELY NP-C
701 N 1ST ST
SPRINGFIELD, IL 62781-0001
Phone number: 217-788-3891
Mailing Address
CASEY AT DIVELY NP-C
701 N 1ST ST
SPRINGFIELD, IL 62781-2565
Phone number: 217-788-3891
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