Healthcare Provider Details

I. General information

NPI: 1275878860
Provider Name (Legal Business Name): KARLI JO ESKEW RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARLI JO GOBRECHT LPN, RN

II. Dates (important events)

Enumeration Date: 12/07/2012
Last Update Date: 12/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E NORTH AVE
FLORA IL
62839-2030
US

IV. Provider business mailing address

PO BOX 155
CHRISTOPHER IL
62822-0155
US

V. Phone/Fax

Practice location:
  • Phone: 618-662-8386
  • Fax:
Mailing address:
  • Phone: 618-724-2436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041364874
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: