Individual
JUSTIN ROSS WHIPPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2808 EAST OUTER DRIVE, MARION, IL 62959-6295
(618) 993-3817
Mailing address
2808 EAST OUTER DRIVE, MARION, IL 62959-2206
(618) 993-3817
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209022448
IL
363LF0000X
Family Nurse Practitioner
209022448
IL
Other
Enumeration date
01/26/2021
Last updated
10/07/2022
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