Individual provider · Type 1 NPI

Paula R. Icenogle

Driver · Colchester, IL

NPI number 1023281847 Active

Practice location

708 Sherry St
Colchester, IL 62326-1176

Call (309) 776-3978 Map

Specialties and licenses

TaxonomyCodeLicense
Driver Primary 172A00000XI25267678827 (IL)

Driver: A person employed to operate a motor vehicle as a carrier of persons or property.

About NPI 1023281847

Paula R. Icenogle's National Provider Identifier is 1023281847, issued on Apr 13, 2008. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Colchester, IL. The record was last updated on Apr 13, 2008.