Individual
CAROL A DEBRUHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, FNP
Contact information
Practice address
535 PARK AVE E, PRINCETON, IL 61356-2537
(815) 875-4531
(815) 876-2119
Mailing address
530 PARK AVE E, PRINCETON, IL 61356-3901
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209002921
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209002921
—
IL
Enumeration date
10/18/2012
Last updated
10/13/2020
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