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NPI Code Detail

MEDICARE: MRS. DEBRA L ANKLAM APN

MEDICARE: MRS. DEBRA L ANKLAM APN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209000261IL

General Provider Information

NPI Number : 1578522561
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBRA L ANKLAM APN
Provider Business Mailing Address
First Line : 101 E 9TH ST
Second Line :
City : PANA
State : IL
Zip : 62557-1716
Country : US
Telephone Number : 217-562-2544
Fax Number : 217-562-6288
Provider Business Practice Location Address
First Line : 101 E 9TH ST
Second Line :
City : PANA
State : IL
Zip : 62557-1716
Country : US
Telephone Number : 217-562-2544
Fax Number : 217-562-6288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2006
Last Update Date : 02/12/2021

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Directions to “ MRS. DEBRA L ANKLAM APN” Practice Location

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