| NPI | 1649345125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE LYNN HOLMAN Np 618-435-4310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209001210) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-08-22 |