Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 209005571 | IL |
NPI | 1003032293 |
---|---|
Provider Name | Tasha Dawn Horsley |
First Address | Joliet, IL 60431-9341 |
Second Address | Joliet, IL 60431-9341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 29/08/2016 |