Individual
MELISSI LYNN STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
25667
TN
364SG0600X
Gerontology Clinical Nurse Specialist
209015906
IL
Other
Enumeration date
05/01/2017
Last updated
01/10/2022
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