Individual
MR. BRUCE DANIEL HASTINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NNP-BC
Contact information
Practice address
415 N 9TH ST STE 4W16, SPRINGFIELD, IL 62702-5303
(217) 545-8000
Mailing address
PO BOX 19676, SPRINGFIELD, IL 62794-9676
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
209.019140
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.019140
LICENSE
IL
Enumeration date
05/03/2019
Last updated
05/03/2019
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