MEDICARE: RONNA R HURREN RN

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
1	163WM0705X	Medical-Surgical Registered Nurse	041325656	IL

General Provider Information

NPI Number	:	1598005993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONNA R HURREN RN

Provider Business Mailing Address
First Line	:	904 MEDICAL PARK DR
Second Line	:	SUITE 2
City	:	EFFINGHAM
State	:	IL
Zip	:	62401-2193
Country	:	US
Telephone Number	:	217-347-2255
Fax Number	:	217-342-6910

Provider Business Practice Location Address
First Line	:	904 MEDICAL PARK DR
Second Line	:	SUITE 2
City	:	EFFINGHAM
State	:	IL
Zip	:	62401-2193
Country	:	US
Telephone Number	:	217-347-2255
Fax Number	:	217-342-6910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2013
Last Update Date	:	02/21/2013

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