Individual
JENNA MARIE WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3106 OUTER DR, MARION, IL 62959-5270
(618) 997-4332
(618) 351-4857
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209023902
IL
Other
Enumeration date
11/18/2021
Last updated
06/10/2025
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