Individual
JOHANNA SHEA ESTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, IBCLC, MSNFNP-C
Contact information
Practice address
4101 N WATER TOWER PL, MOUNT VERNON, IL 62864-6296
(618) 244-6222
(618) 246-1247
Mailing address
8 DOCTORS PARK RD, MOUNT VERNON, IL 62864-6224
(618) 244-5500
(618) 246-1247
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209027598
IL
363LF0000X
Family Nurse Practitioner
Primary
209027598
IL
Other
Enumeration date
03/25/2010
Last updated
06/23/2023
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