Individual
JAMIESON MICHELLE BANMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3133 PINEHURST DR, DECATUR, IL 62521-9145
(217) 520-7145
Mailing address
911 W KAREN DR, DECATUR, IL 62526-1441
(217) 875-4103
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.342804
IL
Other
Enumeration date
09/05/2024
Last updated
09/05/2024
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