Individual
NICOLE M MIETHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3088
Mailing address
611 W PARK ST, URBANA, IL 61801-2529
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
209014942
IL
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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