Individual
LAURA MARANVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
433 N JOHNSON ST, MACOMB, IL 61455-1420
(309) 732-6363
Mailing address
433 N JOHNSON ST, MACOMB, IL 61455-1420
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209017299
IL
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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