Individual
LAURA UTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
405 RUSHING DR, HERRIN, IL 62948-3730
(618) 993-3300
(618) 993-0262
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209013327
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209013327
LICENSE
IL
Enumeration date
10/28/2015
Last updated
05/30/2025
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