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General NPI Number Information
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NPI Number | 1083736391
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Entity Type | Individual
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Provider Name | JULIANNA M. WILLEFORD RN
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Gender | Female
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 08/03/2007
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Provider Practice Location Address
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Address Line | 901 N 1ST ST SUITE 101
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City | SPRINGFIELD
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State | IL
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Zip | 62702-3748
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Country | US
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Telephone | 217-757-7700
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Fax | 217-757-7799
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Provider Business Mailing Address
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Address Line | 710 N 8TH ST
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City | SPRINGFIELD
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State | IL
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Zip | 62702-6324
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Country | US
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Telephone | 217-525-1064
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Fax | 217-525-1651
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 41223452
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License Number State | IL
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