NPI | 1659503217 |
---|---|
Entity Type | Organization |
Authorized Contact | ELLEN M MILLER Nurse Practitioner 618-558-3955 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209001766) |
Enumeration Date | 2009-08-17 |
Last Update Date | 2009-11-30 |