Individual
BETH ANN TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1068 OLYMPIA LN, ROCKFORD, IL 61108-4497
(815) 540-6339
Mailing address
1068 OLYMPIA LN, ROCKFORD, IL 61108-4497
(815) 540-6339
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.374311
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000000
DO NOT HAVE
—
Enumeration date
11/13/2019
Last updated
11/13/2019
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