Individual
MISS MELINDA LUCILLE LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADVANCED PRACTICENUR
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
104 BARBARA ST, EAST PEORIA, IL 61611-4591
(309) 258-1783
(309) 282-1609
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
209011332
IL
Other
Enumeration date
05/14/2014
Last updated
05/14/2014
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