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Individual

JENNIFER ANN CHOATIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
250 W KENWOOD AVE, DECATUR, IL 62526-4371
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
277002089
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00332503
RR MEDICARE
IL
Enumeration date
08/11/2006
Last updated
07/18/2022
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