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1912473273
TIEN T PHAM
PEORIA, IL
NPI
1912473273
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209017737)
Enumeration Date
2018-10-15
Last Update Date
2018-10-15
Business Address
TIEN T PHAM APN, CNP
5405 N KNOXVILLE AVE
PEORIA, IL 61614-5016
Phone number: 309-589-2050
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Mailing Address
TIEN T PHAM APN, CNP
5405 N KNOXVILLE AVE
PEORIA, IL 61614-5016
Phone number: 309-589-2050
Copy
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