Individual
JENNA N DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
100 STAHLHUT DR, LINCOLN, IL 62656-5059
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209027762
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041467948
RN
IL
Enumeration date
12/26/2022
Last updated
09/10/2024
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