Individual
GAIL GREATHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
100 S MAIN ST, WEST SALEM, IL 62476-1202
(618) 456-3727
(618) 456-3774
Mailing address
800 E LOCUST ST, OLNEY, IL 62450-2553
(618) 395-7340
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209002292
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209-002292
LICENSE NUMBER
IL
Enumeration date
03/13/2007
Last updated
01/21/2016
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