Individual
EUTORIA LATRECE DEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
907 S 11TH ST, BELLEVILLE, IL 62226-6802
(618) 540-7015
Mailing address
907 S 11TH ST, BELLEVILLE, IL 62226-6802
(618) 540-7015
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
2015029529
MO
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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