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MRS. CHARLOTTE FAY DOUGLAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
200 E WALNUT ST, WATSEKA, IL 60970-1356
(815) 432-3507
Mailing address
200 E WALNUT ST, WATSEKA, IL 60970-1356
(815) 432-3507

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.010801
IL

Other

Enumeration date
10/17/2013
Last updated
10/17/2013
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