Logan Primary Care
NPI #1902094352 in Herrin, Illinois
Provider Information
- NPI Number
- 1902094352
- Entity Type
- Organization
- Organization Name
- Logan Primary Care
- Primary Specialty
- Nurse Practitioner - Primary Care
- Enumeration Date
- Oct 11, 2007
- Last Updated
- Oct 11, 2007
Practice Location
Authorized Official
- Name
- MRS. TARA G DEATON
- Title
- ADMINISTRATOR
- Phone
- (618) 997-3400
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Primary Care — Primary Care |
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