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Individual

ANDREW W MESSMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APN

Contact information

Practice address
3132 OLD JACKSONVILLE RD, SPRINGFIELD, IL 62704-7400
(217) 588-2600
(217) 757-2021
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(217) 588-2600
(217) 757-2021

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209016934
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041412788
RN LICENSE
IL
Enumeration date
08/10/2017
Last updated
02/22/2019
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