Individual
ALICIA JETZER DEMICHELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(414) 708-0203
Mailing address
2401 W MAIN ST, MARION, IL 62959-1188
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041457974
IL
163W00000X
Registered Nurse
41457974
IL
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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