SHANNON MARIE HOLTHAUS

CHAMPAIGN, IL
NPI1558779058
Former NameSHANNON MARIE HAGAN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209.011667)
Enumeration Date2014-07-28
Last Update Date2015-05-26
Business Address
Mrs. SHANNON MARIE HOLTHAUS APN
1802 S MATTIS AVE
CHAMPAIGN, IL 61821-5923
Phone number: 217-383-3260
Mailing Address
Mrs. SHANNON MARIE HOLTHAUS APN
611 W. PARK ST. BWPC
URBANA, IL 61801-2500
Phone number: 217-383-6792
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