Individual
CASEY J IKEMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
1106 OAK ST, MOUNT CARMEL, IL 62863-2444
(618) 263-6575
Mailing address
1418 COLLEGE DR, MOUNT CARMEL, IL 62863-2638
(618) 262-8621
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
209022299
IL
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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