Individual
LYNETTE EETEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-6880
Mailing address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-5101
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.013158
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.013158
LICENSE
IL
Enumeration date
09/29/2015
Last updated
04/06/2021
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