Individual
MARCIA ANN STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
500 S SCOTT AVE, NEWTON, IL 62448-1665
(618) 783-2144
Mailing address
500 S SCOTT AVE, NEWTON, IL 62448-1665
(618) 783-2144
(618) 783-2541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
209.018377
IL
Other
Enumeration date
04/10/2018
Last updated
10/15/2018
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