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Individual
MARIELLEN PATRICIA ANTMAN
Active
Individual
MARIELLEN PATRICIA ANTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-CNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041202000
IL
363L00000X
Nurse Practitioner
209005116
IL
363LA2200X
Adult Health Nurse Practitioner
Primary
209.005116
IL
Other
Enumeration date
02/12/2007
Last updated
10/13/2016
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