Individual
AMBER LYNN STULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11531 SUNDERLAND RD, MARION, IL 62959-8274
(618) 964-5139
Mailing address
401 W 8TH ST, JOHNSTON CITY, IL 62951-1305
(618) 614-9973
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.129660
IL
Other
Enumeration date
10/26/2023
Last updated
10/26/2023
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