Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 209-006151 | IL |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 209-006151 | IL |
NPI | 1003917717 |
---|---|
Provider Name | Rebecca L Saunders |
First Address | Springfield, IL 62794-9665 |
Second Address | Springfield, IL 62701-1041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 31/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q72684 | (02) |