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1972056869
SHANNON LEIGH FASIG
SPRINGFIELD, IL
NPI
1972056869
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Former Name
SHANNON LEIGH ROLES
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209014497)
Enumeration Date
2016-07-27
Last Update Date
2023-02-03
Business Address
SHANNON LEIGH FASIG FNP
3132 OLD JACKSONVILLE RD
SPRINGFIELD, IL 62704-7400
Phone number: 217-862-0800
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Mailing Address
SHANNON LEIGH FASIG FNP
PO BOX 19248
SPRINGFIELD, IL 62794-9248
Phone number: 217-528-7541
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