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NPI Code Detail

MEDICARE: CARMEKA D HONORABLE APRN

MEDICARE: CARMEKA D HONORABLE APRN
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
1163W00000XRegistered Nurse041382907IL
2363L00000XNurse Practitioner209018332IL

General Provider Information

NPI Number : 1477988087
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEKA D HONORABLE APRN
Provider Business Mailing Address
First Line : 4965 E LOST BRIDGE RD
Second Line :
City : DECATUR
State : IL
Zip : 62521-5139
Country : US
Telephone Number : 217-864-5531
Fax Number :
Provider Business Practice Location Address
First Line : 4965 E LOST BRIDGE RD
Second Line :
City : DECATUR
State : IL
Zip : 62521-5139
Country : US
Telephone Number : 217-864-5531
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2013
Last Update Date : 12/30/2021

Similar Medicare Providers

1699779538 — DANIEL BURTION SMITH M.D.
Practice Location Address:
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1538248786 — HELEN B. KENNEDY NP
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62521-5139
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Practice Fax:
1689026122 — GIHANE FATME HILAL MD
Practice Location Address:
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62521-5139
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1487197034 — AMY MCLAIN APN
Practice Location Address:
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62521-5139
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Directions to “ CARMEKA D HONORABLE APRN” Practice Location

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