Individual
FARREN YUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 N MAIN ST, DECATUR, IL 62523-1206
(217) 362-6262
Mailing address
151 N MAIN ST, DECATUR, IL 62523-1206
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043113217
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639231731
—
IL
Enumeration date
08/21/2017
Last updated
08/21/2017
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