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Individual
JULIE ILLECK
Active
Individual
JULIE ILLECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9283023
FL
363LF0000X
Family Nurse Practitioner
9283023
FL
363LP2300X
Primary Care Nurse Practitioner
Primary
9283023
FL
Other
Enumeration date
02/05/2015
Last updated
03/06/2015
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