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Individual

MRS. EILEEN MCDONALD LENNOX

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
N.P., B.C.

Contact information

Practice address
4201 S WASHINGTON ST, IWU HEALTH CENTER, STUDENT CENTER #210, MARION, IN 46953-4974
(765) 677-2206
(765) 677-2849
Mailing address
4201 S WASHINGTON ST, IWU HEALTH CENTER, STUDENT CENTER #210, MARION, IN 46953-4974
(765) 677-2206
(765) 677-2849

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000247A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000312417
BLUE CROSS
IN
Enumeration date
10/04/2005
Last updated
07/08/2007
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