Individual
SHANNAN HEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
621 E LOCUST ST, GENESEO, IL 61254-1727
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.030719
IL
Other
Enumeration date
10/08/2024
Last updated
10/09/2024
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