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ASHLEY MARMON FNP-C

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1174902696

Individual Registrant:
 ASHLEY  MARMON FNP-C
Gender: F
Not Sole Proprietor

Location and contact information for practice:
12528 SR 78  HAVANA, IL 62644-6866 US
Tel: 309-543-4253  Fax: 309-543-1060

Contact information for business:
1301 W JEFFERSON ST APT 26 E MORTON, IL 61550-1378 US
Tel: 309-265-5345  Fax: --

Registration Information:
NPI: 1174902696
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
IL363LF0000X

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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