Individual
GAYLIN MANION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1167 FORTUNE BLVD, SHILOH, IL 62269-7377
(618) 207-6900
(618) 207-6901
Mailing address
PO BOX 419059, SAINT LOUIS, MO 63141-9059
(618) 207-6900
(618) 207-6901
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209012822
IL
Other
Enumeration date
05/29/2015
Last updated
02/02/2023
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