Individual
BROOKE MICHELLE VANCOPPENOLLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
707 W 4TH ST, MINONK, IL 61760-1425
(815) 579-4093
Mailing address
707 W 4TH ST, MINONK, IL 61760-1425
(815) 579-4093
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
041316088
IL
Other
Enumeration date
06/26/2021
Last updated
06/26/2021
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