Individual
COURTNEY JANIEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62702-5324
(217) 544-6464
Mailing address
2345 S RICHMOND RD, DECATUR, IL 62521-4871
(708) 373-1183
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041403319
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209026748
IL
Other
Enumeration date
09/20/2022
Last updated
01/31/2023
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