Individual
DESTINY R DANNELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1200 N EAST ST, OLNEY, IL 62450-2432
(618) 395-5222
(618) 395-8552
Mailing address
1200 N EAST ST, OLNEY, IL 62450-2432
(618) 395-5222
(618) 395-8552
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209019945
IL
Other
Enumeration date
08/28/2019
Last updated
04/13/2021
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