Individual
SARA NICOLE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1025 MAINE ST, QUINCY, IL 62301-4096
(217) 222-6550
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4096
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209031580
IL
363LA2100X
Acute Care Nurse Practitioner
209031580
IL
363LG0600X
Gerontology Nurse Practitioner
209031580
IL
Other
Enumeration date
01/28/2025
Last updated
02/10/2025
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