Individual
LESLIE ANN FERMIN DEPAYSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2501
(217) 383-3610
Mailing address
1505 MONTGOMERY ST, URBANA, IL 61802-4742
(561) 990-9587
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.028491
IL
Other
Enumeration date
04/09/2024
Last updated
04/09/2024
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