Individual
MONA VISNIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 W 2ND ST, BLOOMINGTON, IN 47403-2317
(812) 676-4102
Mailing address
601 W 2ND ST, BLOOMINGTON, IN 47403-2317
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71009956A
IN
Other
Enumeration date
04/14/2020
Last updated
04/14/2020
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