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NPI Code Detail

MEDICARE: DARLENE R SEVERIN NP

MEDICARE:   DARLENE R SEVERIN  NP
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
1363L00000XNurse Practitioner209008436IL

General Provider Information

NPI Number : 1396042099
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARLENE R SEVERIN NP
Provider Business Mailing Address
First Line : PO BOX 6004
Second Line :
City : URBANA
State : IL
Zip : 61803-6004
Country : US
Telephone Number : 217-326-8300
Fax Number :
Provider Business Practice Location Address
First Line : 610 N LINCOLN AVE
Second Line :
City : URBANA
State : IL
Zip : 61801-2432
Country : US
Telephone Number : 217-383-6555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2011
Last Update Date : 06/18/2012

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Directions to “ DARLENE R SEVERIN NP” Practice Location

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