Individual
SHONTE MOELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
815 W COLLEGE AVE APT 4, JACKSONVILLE, IL 62650-3800
(217) 220-8136
Mailing address
514 N FAYETTE ST, JACKSONVILLE, IL 62650-1936
(217) 220-9627
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
IL
Other
Enumeration date
07/17/2017
Last updated
07/17/2017
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