Individual
DANIELLE SPAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
319 E. MADISON ST., SUITE 2D, SPRINGFIELD, IL 62701
(866) 933-8387
Mailing address
319 E. MADISON ST., SUITE 2D, SPRINGFIELD, IL 62701
(866) 933-8387
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041417384
IL
363LF0000X
Family Nurse Practitioner
Primary
277001571
IL
363LF0000X
Family Nurse Practitioner
377001525
IL
Other
Enumeration date
07/25/2018
Last updated
06/10/2022
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