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Individual

YAW OPOKU-AGYEMANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APN

Contact information

Practice address
1505 EASTLAND DR STE 320, BLOOMINGTON, IL 61701-7912
(309) 662-3311
(309) 662-9709
Mailing address
1505 EASTLAND DR STE 320, BLOOMINGTON, IL 61701-7912
(309) 662-3311
(309) 662-9709

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209019808
IL

Other

Enumeration date
10/29/2019
Last updated
10/29/2019
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