Individual
ANGELA DURR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 N MAIN ST, DECATUR, IL 62523-1206
(217) 362-6262
(217) 362-6290
Mailing address
151 N MAIN ST, DECATUR, IL 62523-1206
(217) 362-6262
(217) 362-6290
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
41349404
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639231731
—
IL
Enumeration date
08/21/2017
Last updated
07/21/2022
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