JORDAN KELLY MANDEVILLE

SPRINGFIELD, IL
NPI1972387504
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: IL  209028150)
Enumeration Date2023-08-23
Last Update Date2023-08-23
Business Address
JORDAN KELLY MANDEVILLE
1020 S 5TH ST
SPRINGFIELD, IL 62703-2312
Phone number: 217-544-3143
Mailing Address
JORDAN KELLY MANDEVILLE
61 BOURBAKI RD
NEW BERLIN, IL 62670-4570
Phone number: 217-801-8732
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