Individual
CARLI ANN LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
401 N MAIN ST, ROANOKE, IL 61561-7585
(309) 923-2661
Mailing address
401 N MAIN ST, ROANOKE, IL 61561-7585
(309) 923-2661
(309) 923-7628
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
209.028999
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
209028999
IL
Other
Enumeration date
02/21/2024
Last updated
10/25/2024
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