Individual
MARY N HOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
715 W JACKSON ST, PETERSBURG, IL 62675-1436
(217) 632-7344
Mailing address
715 W JACKSON ST, PETERSBURG, IL 62675-1436
(217) 632-7344
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
—
IL
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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