Individual
AUDRA DANIELLE WASHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
403 E 1ST ST, DIXON, IL 61021
(815) 284-5710
(815) 285-5893
Mailing address
403 E 1ST ST, DIXON, IL 61021-3187
(815) 284-5710
(815) 285-5893
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209016371
IL
Other
Enumeration date
08/17/2017
Last updated
07/24/2019
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