Staten Family Practice Pllc

NPI #1407474083 in Gillespie, Illinois

Provider Information

NPI Number
1407474083
Entity Type
Organization
Organization Name
Staten Family Practice Pllc
Primary Specialty
Clinic/Center
Enumeration Date
Jul 9, 2020
Last Updated
Jul 9, 2020

Practice Location

Address
500 W VIRGINIA AVE
ZIP Code
62033-1025
Phone
(217) 851-5270

Authorized Official

Name
ROSEMARY STATEN, FNP
Title
APRN
Phone
(217) 851-5270

Specialties & Taxonomy Codes

Specialty
Clinic/Center

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