Individual
BLAIR NICOLE ANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
101 E 9TH ST, PANA, IL 62557-1716
(217) 562-6246
(217) 562-6288
Mailing address
101 E 9TH ST, PANA, IL 62557-1716
(217) 562-6246
(217) 562-6288
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
041354011
IL
Other
Enumeration date
07/17/2013
Last updated
02/17/2021
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