Individual
CARRIE NICOLE FISHER STALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
530 NE GLEN OAK AVE, OSF ST FRANCIS MEDICAL CENTER/TRAUMA SERVICE, PEORIA, IL 61637
(309) 655-2295
Mailing address
530 NE GLEN OAK AVE, OSF ST FRANCIS MEDICAL CENTER/TRAUMA SERVICE, PEORIA, IL 61637
(309) 655-2295
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209008382
IL
Other
Enumeration date
10/13/2010
Last updated
10/13/2010
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