Individual
JENNIFER LEIGH SCALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
37 DEVINE DR, RIVERTON, IL 62561-9627
(217) 891-3063
(217) 891-3063
Mailing address
37 DEVINE DR, RIVERTON, IL 62561-9627
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209008285
IL
363LF0000X
Family Nurse Practitioner
209008285
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209008285
—
IL
Enumeration date
10/31/2011
Last updated
07/11/2023
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