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MRS. STEPHANIE NICHOLE RAFE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
201 S 17TH ST, HERRIN, IL 62948-2203
(618) 201-8943
(618) 201-8943
Mailing address
201 S 17TH ST, HERRIN, IL 62948-2203
(618) 201-8943

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.124969
IL

Other

Enumeration date
11/23/2017
Last updated
11/23/2017
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