Individual
JUSTYNA ANNA KOSCIELNIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(619) 779-1392
Mailing address
2015 TRACY DR APT 3, BLOOMINGTON, IL 61704-7523
(619) 779-1392
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209.023771
IL
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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