Individual
MARK NANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8600 STATE ROUTE 91 STE 250, PEORIA, IL 61615-7831
(309) 692-5393
(309) 692-2538
Mailing address
8600 STATE ROUTE 91 STE 250, PEORIA, IL 61615-7831
(309) 692-5393
(309) 692-2538
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209011635
IL
Other
Enumeration date
07/10/2014
Last updated
06/13/2016
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