Individual
MS. ELAINE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2502 E EMPIRE ST, BLOOMINGTON, IL 61704-3738
(309) 662-6467
(309) 664-2689
Mailing address
1109 E OLIVE ST, BLOOMINGTON, IL 61701-5550
(309) 829-9914
Taxonomy
Speciality
Code
Description
License number
State
163WX0800X
Orthopedic Registered Nurse
Primary
041.382454
IL
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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