Individual
HANNAH LAKE-RAYBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CNM, NP-C
Contact information
Practice address
611 W. PARK ST., OB/GYN, URBANA, IL 61801
(217) 383-3140
(217) 383-4966
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
209018186
IL
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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