William Scott Childress
Licensed Practical Nurse in Lawrenceville, IL. Individual provider (NPI-1).
NPI number1053199232
StatusActive
Last updated in NPPESSep 19, 2023
Details
- NPI
- 1053199232
- Entity type
- Individual (NPI-1)
- Name
- William Scott Childress
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 19, 2023
- Certification date
- Sep 19, 2023
- Last updated
- Sep 19, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 043123069 | IL | Yes |
Practice location
2101 James StLawrenceville, IL 62439-2027
Phone 618-943-3302
Mailing address
2101 James StLawrenceville, IL 62439-2027
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