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1477137693
EBONY SHARETTE PENN
BELLEVILLE, IL
NPI
1477137693
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209022466)
Enumeration Date
2021-05-12
Last Update Date
2021-05-12
Business Address
EBONY SHARETTE PENN
1720 SHADOW RIDGE CT APT H
BELLEVILLE, IL 62221-3914
Phone number: 618-409-3082
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Mailing Address
EBONY SHARETTE PENN
1720 SHADOW RIDGE CT APT H
BELLEVILLE, IL 62221-3914
Phone number: 618-409-3082
Copy
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