Individual
TARISSA LA SHELL STANCIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
932 23RD AVE, BELLWOOD, IL 60104-2501
(708) 426-8293
Mailing address
932 23RD AVE, BELLWOOD, IL 60104-2501
(708) 632-4200
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
Primary
041300689
IL
Other
Enumeration date
12/28/2019
Last updated
12/28/2019
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