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General NPI Number Information
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NPI Number | 1033563754
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Entity Type | Organization
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Legal Business Name | WEST FRANKFORT FAMILY CARE LLC
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 406 W SAINT LOUIS ST
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City | WEST FRANKFORT
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State | IL
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Zip | 62896-1956
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Country | US
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Telephone | 618-937-1880
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Fax |
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Provider Business Mailing Address
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Address Line | 406 W SAINT LOUIS ST
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City | WEST FRANKFORT
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State | IL
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Zip | 62896-1956
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/FAMILY NURSE PRACTITIONER
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Name | DENISE ORRILL
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Credential |
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Telephone | 618-249-6203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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