| NPI | 1427802545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER GIBB Ap RN, Owner, Director 309-261-1102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-04-17 |