Veteran's Administration

NPI #1043323793 in Decatur, Illinois

Provider Information

NPI Number
1043323793
Entity Type
Organization
Organization Name
Veteran's Administration
Primary Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date
Aug 16, 2006
Last Updated
Aug 22, 2020

Practice Location

Address
3035 E MOUND RD
ZIP Code
62526-9650
Phone
(217) 875-2670

Authorized Official

Name
MS. GERALDINE THORNHILL WIRTH, A.P.R.N.
Title
NURSE PRACTITIONER
Phone
(217) 875-2670

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)Federally Qualified Health Center (FQHC)

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