Individual
BETH ALLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FPA APRN NP-C
Contact information
Practice address
701 COLLEGE RD, LEBANON, IL 62254-1291
(618) 537-6502
Mailing address
9045 E KIRSCH RD, TROY, IL 62294-2527
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277000007
IL
363LS0200X
School Nurse Practitioner
277000007
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
277000007
APRN
IL
Enumeration date
01/16/2015
Last updated
08/17/2021
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