Organization Name: | OKAWVILLE FAMILY CARE LLC |
NPI Number: | 1154782530 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DENISE ORRILL (OWNER/FAMILY NURSE PRACTITIONER) |
Mailing Address: | 207 E Belleville Okawville |
State: | IL US |
Postal Code: | 62271 |
Phone Number: | 6182431090 |
Fax Number: | 6182431094 |
NPI Enumeration Date: | 03/14/2016 |
NPI Last Update Date: | 03/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |