Individual
LISA VOGT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
20 S 27TH ST, BELLEVILLE, IL 62226-6724
(618) 233-4132
Mailing address
4313 SEQUOIA PL, BELLEVILLE, IL 62226-7803
(618) 830-8988
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
041333362
IL
Other
Enumeration date
01/11/2018
Last updated
06/16/2018
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