Individual
HAILEY NOSALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
6812 STATE ROUTE 162 STE 120, MARYVILLE, IL 62062-8586
(618) 288-0044
Mailing address
120 OAKSHIRE DR E, GLEN CARBON, IL 62034-8528
(618) 790-8009
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/31/2020
Last updated
10/18/2022
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