Individual
STACEY L. PUNTNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
209 NW 11TH ST, FAIRFIELD, IL 62837-1218
(618) 842-4470
Mailing address
PO BOX 155, CHRISTOPHER, IL 62822-0155
(618) 724-2436
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043113187
IL
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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