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 Date2025-05-02
Business Address
JENNIFER DERRICKSON APRN
2512 HURST DR
MATTOON, IL 61938-9200
Phone number: 217-258-5900
Mailing Address
JENNIFER DERRICKSON APRN
611 W PARK ST FAPC
URBANA, IL 61801
Phone number:
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