Individual
HEATHER E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-4644
(217) 255-4150
(217) 258-2579
Mailing address
PO BOX 372, ATTN INSURANCE CREDENTIALING, MATTOON, IL 61938-0372
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209.018045
IL
363LF0000X
Family Nurse Practitioner
Primary
209-018045
IL
Other
Enumeration date
09/10/2018
Last updated
03/04/2024
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