Individual
AMY JESSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1701 W CURTIS ROAD, FAMILY MEDICINE/CONVENIENT CARE, CHAMPAIGN, IL 61822
(217) 365-6203
(217) 326-1234
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209006816
IL
363LF0000X
Family Nurse Practitioner
Primary
277002040
IL
Other
Enumeration date
03/05/2008
Last updated
04/01/2024
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