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Individual

MRS. MARYANN H. PASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
2 MEMORIAL DR, SUITE 122, ALTON, IL 62002-6723
(618) 465-2550
(618) 462-4167
Mailing address
2 MEMORIAL DR, SUITE 122, ALTON, IL 62002-6723
(618) 465-2550
(618) 462-4167

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041272946
IL
163W00000X
Registered Nurse
123658
MO
363L00000X
Nurse Practitioner
123658
MO
363LW0102X
Women's Health Nurse Practitioner
Primary
209001958
IL

Other

Enumeration date
12/29/2006
Last updated
10/11/2012
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