Individual
JESSICA BRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
400 N PLEASANT AVE, CENTRALIA, IL 62801-3056
(618) 436-8000
Mailing address
518 S 1ST ST SE, CLAY CITY, IL 62824-1208
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.396742
IL
363L00000X
Nurse Practitioner
Primary
209035950
IL
Other
Enumeration date
06/24/2026
Last updated
07/29/2026
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