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1922833615
BOMINA OTTO
URBANA, IL
NPI
1922833615
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: IL 209030394)
Enumeration Date
2024-09-03
Last Update Date
2024-12-27
Business Address
BOMINA OTTO APRN
611 W PARK ST
URBANA, IL 61801-2501
Phone number: 217-383-3311
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Mailing Address
BOMINA OTTO APRN
611 W PARK FAPC
URBANA, IL 61802
Phone number: 217-902-6954
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