JENNIFER DERRICKSON

MATTOON, IL
NPI1538922323
Former NameJENNIFER SHOCKLEY
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner Family
(Licence: IL  209028677)
Enumeration Date2024-02-05
Last Update Date2024-02-05
Business Address
JENNIFER DERRICKSON APRN
1000 HEALTH CENTER DR
MATTOON, IL 61938-4644
Phone number: 217-258-2114
Mailing Address
JENNIFER DERRICKSON APRN
609 WABASH AVE
MATTOON, IL 61938-4312
Phone number: 217-508-9256
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