Organization · Type 2 NPI

Memorial Hospital Association

Family Nurse Practitioner · Augusta, IL

NPI number 1275979031 Active

Practice location

204 Center St
Augusta, IL 62311-1228

Call (217) 392-2108 Map

Fax (217) 392-2110

Mailing address

PO Box 160
Carthage, IL 62321-0160

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Family Nurse Practitioner Primary	363LF0000X	None listed

Family Nurse Practitioner: Definition to come...

2 other providers at this address

Karen Jane Land, A.R.N.P.Nurse Practitioner Augusta, IL NPI 1801824909
Luanne Dee Johnson, NURSE PRACTITIONERNurse Practitioner Augusta, IL NPI 1922096601

NPI record

NPI: 1275979031
Entity type: Organization (Type 2)
Issued: May 20, 2013
Last updated: May 20, 2013
Status: Active
Subpart: Yes of Memorial Hospital Association

Other names

<unavail>
Memorial Medical Augusta Clinic · doing business as

Authorized official

Jessie Fifer
Special Projects Coordinator
(217) 357-6594

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1275979031

Memorial Hospital Association's National Provider Identifier is 1275979031, issued on May 20, 2013. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Augusta, IL. The record was last updated on May 20, 2013.