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Individual

MAXITA M PINAWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2300 N ROCKTON AVE, ROCKFORD, IL 61103-3619
(815) 971-2800
(815) 971-9850
Mailing address
2300 N ROCKTON AVE, ROCKFORD, IL 61103-3619
(815) 971-2800
(815) 971-9850

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209006050
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NON PAR
IL
Enumeration date
06/15/2006
Last updated
11/30/2012
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