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Individual

MS. DONNETTA HOUSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
50 NORTHGATE INDUSTRIAL DR, GRANITE CITY, IL 62040-6805
(618) 877-4420
Mailing address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(888) 924-3786

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
2016025238
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2016025238
RN
MO
Enumeration date
01/04/2024
Last updated
04/30/2026
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