Organization
STATEN FAMILY PRACTICE PLLC
Active
Other names
Staten Family Practice PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARY STATEN FNP (APRN)
(217) 851-5270
Entity
Organization
Contact information
Practice address
500 W VIRGINIA AVE, GILLESPIE, IL 62033-1025
(217) 851-5270
Mailing address
500 W VIRGINIA AVE, GILLESPIE, IL 62033-1025
(217) 851-5270
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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