Individual
ELIZABETH LAUREN STUART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
751 N RUTLEDGE ST STE 1100, SPRINGFIELD, IL 62702-4968
(217) 545-8000
(217) 788-5504
Mailing address
PO BOX 19636, SPRINGFIELD, IL 62794-9636
(217) 545-8000
(217) 788-5504
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.402814
IL
363LF0000X
Family Nurse Practitioner
Primary
209.016146
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209-016146
STATE LICENSE
IL
Enumeration date
10/16/2017
Last updated
12/09/2020
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