Individual
MCKENNA IVY SHOFROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
20 PROFESSIONAL PARK DR STE B, MARYVILLE, IL 62062-5830
(618) 288-1480
(888) 718-4696
Mailing address
20 PROFESSIONAL PARK DR STE B, MARYVILLE, IL 62062-5830
(618) 288-1480
(888) 718-4696
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
041521566
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417916099
—
IL
Enumeration date
02/22/2022
Last updated
02/22/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us