Individual
DR. STEPHANIE BROOM NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
220 E RYDER ST, LITCHFIELD, IL 62056-2033
(217) 324-2433
(217) 324-3377
Mailing address
220 E RYDER ST, LITCHFIELD, IL 62056-2033
(217) 324-2433
(217) 324-3377
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006884001
BLUE CROSS BLUE SHIELD IL
IL
Enumeration date
01/19/2007
Last updated
07/08/2007
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