Individual
KATIE LYNN HASSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 370-1605
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(616) 822-3833
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209022922
IL
Other
Enumeration date
02/26/2021
Last updated
02/26/2021
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