Individual
MS. BLAIR ELIZABETH BONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
13745 MARY LN, AVISTON, IL 62216-4732
(618) 567-9821
(618) 939-9836
Mailing address
PO BOX 306, COLUMBIA, IL 62236-0306
(618) 567-9821
(618) 939-9836
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.015303
IL
363LF0000X
Family Nurse Practitioner
209105303
IL
Other
Enumeration date
12/19/2016
Last updated
09/17/2021
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