Individual
MICHELE LYNN MOUNCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-3000
Mailing address
125 HEATHERVIEW DR, EAST PEORIA, IL 61611
(309) 655-3000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP61333948
WA
363LA2100X
Acute Care Nurse Practitioner
209.012995
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209012995
IL
Other
Enumeration date
08/31/2015
Last updated
12/12/2023
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