Individual
JEWEL SCROGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
805 SAINT THOMAS LN, CAHOKIA, IL 62206-1810
(618) 578-3052
Mailing address
805 SAINT THOMAS LN, CAHOKIA, IL 62206-1810
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043112591
IL
164W00000X
Licensed Practical Nurse
2017041810
MO
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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