Individual
LEE VIRGINIA MURRIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
305 EAST JOE DRIVE, AMBOY, IL 61310
(815) 857-3044
Mailing address
623 E CHAMBERLIN ST, DIXON, IL 61021-2223
(815) 742-5209
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.016710
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400424155
MEDICARE PTAN
IL
Enumeration date
10/03/2017
Last updated
09/05/2018
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