Organization Name: | WEST FRANKFORT FAMILY CARE LLC |
NPI Number: | 1033563754 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DENISE ORRILL (OWNER/FAMILY NURSE PRACTITIONER) |
Mailing Address: | 406 W Saint Louis St West Frankfort |
State: | IL US |
Postal Code: | 628961956 |
Phone Number: | 6189371880 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2016 |
NPI Last Update Date: | 04/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |