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Individual

LISA K SPRAGUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
868 MORTIMER ST, BARRY, IL 62312-1249
(217) 335-2343
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
209012735
IL
363LF0000X
Family Nurse Practitioner
Primary
209012735
IL

Other

Enumeration date
04/27/2015
Last updated
09/26/2024
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