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Individual

MARVETTA BACHUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
19721 LAKE PARK DR, LYNWOOD, IL 60411-1556
(773) 979-2529
Mailing address
19721 LAKE PARK DR, LYNWOOD, IL 60411-1556
(773) 979-2529

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.4355332
IL
163WI0500X
Infusion Therapy Registered Nurse
041.4355332
IL
163WM1400X
Nurse Massage Therapist (NMT)
041.4355332
IL
163WP0200X
Pediatric Registered Nurse
041.4355332
IL
163WS0121X
Plastic Surgery Registered Nurse
041.4355332
IL

Other

Enumeration date
11/16/2017
Last updated
11/16/2017
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