Individual
DAWN MARIE COUSINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
Mailing address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
277000149
IL
363LF0000X
Family Nurse Practitioner
309009925
IL
Other
Enumeration date
07/07/2016
Last updated
11/26/2021
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