Individual
MS. DEBRA LYNN ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
4124 ALBY ST, ALTON, IL 62002-4478
(618) 466-1010
Mailing address
3213 MORKEL DR, GODFREY, IL 62035-1842
(618) 466-3173
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.076178
IL
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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