Individual
DAWN AMY TRAVELSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
988 N ILLINOIS ROUTE 3, WATERLOO, IL 62298-1000
(618) 939-4444
(618) 939-4181
Mailing address
211 DALE ST, WATERLOO, IL 62298-1404
(618) 610-9689
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0043069901
IL
Other
Enumeration date
01/30/2007
Last updated
04/06/2011
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