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1699528596
LESLIE ANN FERMIN DEPAYSO
URBANA, IL
NPI
1699528596
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209.028491)
Enumeration Date
2024-04-09
Last Update Date
2024-04-09
Business Address
LESLIE ANN FERMIN DEPAYSO APRN
611 W PARK ST
URBANA, IL 61801-2501
Phone number: 217-383-3610
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Mailing Address
LESLIE ANN FERMIN DEPAYSO APRN
1505 MONTGOMERY ST
URBANA, IL 61802-4742
Phone number: 561-990-9587
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