Individual
SHYLAH NICOLLE HEATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
11531 SUNDERLAND RD, MARION, IL 62959-8274
(618) 964-5139
Mailing address
105 S 11TH ST, HERRIN, IL 62948-3653
(618) 521-0766
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.133858
IL
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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