Individual
MARISSA BETH HAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11020 STATE ROUTE 250, LAWRENCEVILLE, IL 62439-3379
(618) 943-3754
(618) 943-3657
Mailing address
11362 COUNTRY CLUB RD, LAWRENCEVILLE, IL 62439-4325
(618) 943-3754
(618) 943-3657
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041425862
IL
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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