Individual
JULIE RAE WETMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC, NNP
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2500
(217) 383-3266
(217) 383-3463
Mailing address
611 W. PARK ST, FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209-001827
IL
363LF0000X
Family Nurse Practitioner
209001827
IL
363LN0000X
Neonatal Nurse Practitioner
2002008638
MO
363LN0000X
Neonatal Nurse Practitioner
Primary
209001827
IL
363LN0005X
Critical Care Neonatal Nurse Practitioner
2002008638
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
$$$$$$$$$
—
IL
Enumeration date
04/26/2007
Last updated
10/16/2024
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