Individual
SHANNA COYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1128 JAIMEE LN, LIBERTYVILLE, IL 60048
(443) 310-3602
Mailing address
1128 JAIMEE LN, LIBERTYVILLE, IL 60048-4480
(443) 310-3602
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
041459910
IL
Other
Enumeration date
06/21/2018
Last updated
06/21/2018
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