Individual
JAMIE HEIBNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11531 SUNDERLAND RD, MARION, IL 62959-8274
(618) 889-8654
Mailing address
22087 OLD DELTA MINE RD, MARION, IL 62959-8766
(618) 889-8654
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.126087
IL
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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