Individual
LAURA DETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
901 MEDICAL PARK DR, SUITE 100, EFFINGHAM, IL 62401-2191
(217) 347-3003
(217) 347-3005
Mailing address
901 MEDICAL PARK DR, SUITE 100, EFFINGHAM, IL 62401-2191
(217) 347-3003
(217) 347-3005
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041254809
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2500075
BCBS
IL
01
—
702089
HEALTHLINK
—
Enumeration date
02/04/2009
Last updated
02/04/2009
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