Individual
BROOKE MARIE WANGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2532 FARRAGUT DR, SPRINGFIELD, IL 62704-1433
(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
209022704
IL
Other
Enumeration date
05/05/2021
Last updated
05/05/2021
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