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Individual

MRS. DEBORAH L NIELSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N. A.P.N

Contact information

Practice address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9774
(815) 844-5343
(815) 844-5715
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209.007237
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
209.007237
STATE LICENSE
IL
Enumeration date
09/05/2008
Last updated
06/25/2021
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