Individual
JAELYN LOIS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
70 MEADOWVIEW CTR STE 200, KANKAKEE, IL 60901-2063
(815) 802-0000
(815) 935-1000
Mailing address
PO BOX 95, BOURBONNAIS, IL 60914-0095
(815) 802-0000
(815) 935-1000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71010380A
IN
363LF0000X
Family Nurse Practitioner
Primary
209021128
IL
Other
Enumeration date
03/29/2020
Last updated
02/06/2024
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