Organization
DRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS BROOKE NICOLE ANDE RN (REGISTERED NURSE)
(618) 841-7217
Entity
Organization
Contact information
Practice address
2707 UPCHURCH ST, ELDORADO, IL 62930-2344
(618) 841-7217
Mailing address
2707 UPCHURCH ST, ELDORADO, IL 62930-2344
(618) 841-7217
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041395573
IL
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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