Individual
MARY LAIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-1255
(217) 352-9658
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-1255
(217) 352-9658
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277003714
IL
363LF0000X
Family Nurse Practitioner
71006877A
IN
Other
Enumeration date
02/20/2017
Last updated
02/18/2025
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