Individual
MRS. NICHOLE LYNN JUSTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(618) 549-0721
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209023758
IL
363LF0000X
Family Nurse Practitioner
209.023758
IL
Other
Enumeration date
09/05/2021
Last updated
01/23/2024
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