Individual
DEBRA RUTH GROMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2220 N MONROE ST, SUITE 1, DECATUR, IL 62526-6304
(217) 875-1886
(217) 875-3120
Mailing address
504 W JACKSON ST, SULLIVAN, IL 61951-1360
(217) 728-4943
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
209000998
IL
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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