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1962020560
AMY JO FUGATE
MATTOON, IL
NPI
1962020560
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: IL 209021558)
Enumeration Date
2020-07-09
Last Update Date
2024-01-16
Business Address
AMY JO FUGATE AGPCNP
1000 PALM AVE
MATTOON, IL 61938-6031
Phone number: 888-365-6271
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Mailing Address
AMY JO FUGATE AGPCNP
15730 N STATE HIGHWAY 130
NEWTON, IL 62448-3273
Phone number: 217-663-5414
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