Individual
JANA TULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
400 N PLEASANT AVE, CENTRALIA, IL 62801-3056
(618) 436-8000
Mailing address
561 W ALTON ST, NASHVILLE, IL 62263-1370
(618) 436-8000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.015709
IL
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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