Individual
JENNIFER NICOLE BORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
210 W MCKINLEY AVE, DECATUR, IL 62526-5858
(217) 876-6600
Mailing address
205 W FORSYTH RD, FORSYTH, IL 62535-4086
(217) 413-7196
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-018415
IL
Other
Enumeration date
10/26/2018
Last updated
10/26/2018
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