Individual
MRS. JENISE ERVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
142 INDIAN SPRINGS DR, SANDWICH, IL 60548-1902
(800) 971-8293
Mailing address
514 ILLINOIS ST, PARK FOREST, IL 60466-1076
(708) 481-8179
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001534A
IN
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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