TIFFANY NICOLE LOGAN

CHAMPAIGN, IL
NPI1790359495
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP2300X Nurse Practitioner, Primary Care
(Licence: IL  209.021232)
Enumeration Date2021-05-17
Last Update Date2022-12-08
Business Address
TIFFANY NICOLE LOGAN NP
1701 CURTIS RD
CHAMPAIGN, IL 61822-9678
Phone number: 217-365-6201
Mailing Address
TIFFANY NICOLE LOGAN NP
2302 BELMORE DR
CHAMPAIGN, IL 61821
Phone number:
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