Individual
MRS. LORI MEINTS GUDAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
411 MAXINE DR, MORTON, IL 61550-2495
(309) 266-9757
Mailing address
3916 W CRESTRIDGE CT, PEORIA, IL 61615-8958
(309) 253-6433
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209017105
IL
Other
Enumeration date
05/03/2018
Last updated
05/03/2018
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