Stacey Harminson PA-C

NPI 1710093018 - Physician Assistant - 363A00000X

NPI Details
NPI 1710093018
Gender Female
Enumeration Date 08/21/2006
Last Updated 09/28/2010
Entity Type Individual
Active Over 10 years ago
Practice Location
1005 HEALTH CENTER DRIVE
SUITE 104
MATTOON IL, 61938, US
Phone (217) 258-2178
Fax (217) 258-4024
Business Location
1005 HEALTH CENTER DRIVE
SUITE 104
MATTOON IL, 61938, US
Phone (217) 258-2178
Fax (217) 258-4024
Toxanomy
Taxonomy Code 363A00000X
License State Illinois
License Number 085-001452
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According to our database, Stacey Harminson PA-C NPI is 1710093018, taxonomy code is 363A00000X and license number is 085-001452, license state is located at Illinois. Stacey Harminson PA-C physically located at 1005 Health Center Drive, Mattoon IL, 61938. NPI Number Stacey Harminson PA-C has the Individual type.

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1710093018 NPI number is provided on an as is basis without warranty of any kind. 1710093018 is maintained by the National Plan & Provider Enumeration System. The contents of Stacey Harminson PA-C are for informational purposes only.