Individual
MARY LYNN LASSETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
322 EAST LINCOLN STREET, HARRISBURG, IL 62946
(618) 926-0991
Mailing address
322 EAST LINCOLN STREET, HARRISBURG, IL 62946
(618) 926-0991
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043080935
IL
Other
Enumeration date
08/07/2021
Last updated
08/07/2021
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