Airline Care Clinic PLLC
Nurse Practitioner, Family in East Alton, IL. Organization (NPI-2).
NPI number1992556427
StatusActive
Last updated in NPPESApr 1, 2024
Details
- NPI
- 1992556427
- Entity type
- Organization (NPI-2)
- Legal business name
- Airline Care Clinic PLLC
- Organization subpart
- No
- Enumeration date
- Apr 1, 2024
- Certification date
- Apr 1, 2024
- Last updated
- Apr 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Practice location
33 E Airline DrEast Alton, IL 62024-1703
Phone 618-908-8602
Mailing address
33 E Airline DrEast Alton, IL 62024-1703
Authorized official
Elizabeth Dykeman
Owner
3143749965
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