Individual
LATIA RACHELLE SUMMERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
721 E COURT ST, PARIS, IL 61944-2460
(217) 465-4141
Mailing address
721 E COURT ST, PARIS, IL 61944-2460
(217) 465-4141
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209025042
IL
363LF0000X
Family Nurse Practitioner
F08210851
IL
Other
Enumeration date
01/26/2022
Last updated
03/11/2024
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