Individual
BETHANI CHRISTIANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 FORT JESSE RD STE 110, NORMAL, IL 61761-6286
(309) 661-6290
Mailing address
2200 FORT JESSE RD STE 110, NORMAL, IL 61761-6286
(309) 661-6290
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209014126
IL
Other
Enumeration date
03/24/2016
Last updated
02/08/2021
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