Individual
MISS MARY A MARVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNS BC
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 671-1539
(309) 671-7528
Mailing address
100 APPELLATE CT, EAST PEORIA, IL 61611-1402
(309) 698-1195
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
041290023
IL
Other
Enumeration date
08/26/2011
Last updated
08/26/2011
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