Individual
MS. SALLY JANE MUICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
180 S 3RD ST, 300, BELLEVILLE, IL 62220-1952
(618) 233-5480
(618) 222-4972
Mailing address
180 S 3RD ST, 300, BELLEVILLE, IL 62220-1952
(618) 233-5480
(618) 222-4972
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
099684
MO
363LG0600X
Gerontology Nurse Practitioner
Primary
209006132
IL
Other
Enumeration date
09/06/2006
Last updated
11/28/2012
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