Organization · Type 2 NPI
Backroad Health Care Inc
Family Nurse Practitioner · Centralia, IL
NPI number
1134582018
Active
Practice location
211 S Perrine Ave
Centralia, IL 62801-3635
Fax (888) 980-2931
Mailing address
314 S Poplar St Unit 864
Centralia, IL 62801-0848
Other practice locations
- 7825A E Grant Rd, Walnut Hill, IL 62893-1613 · (618) 545-0707
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
3 other providers at this address
Other family nurse practitioner providers in Centralia
About NPI 1134582018
Backroad Health Care Inc's National Provider Identifier is 1134582018, issued on Mar 30, 2016. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Centralia, IL. The record was last updated on Mar 18, 2019.