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Leah Gravesen
Family Nurse Practitioner in Streator, Illinois
NPI 1477191336

Leah Gravesen is a Family Nurse Practitioner based in Dwight, IL and is specialized in Family. Leah Gravesen practices in Streator, IL. The NPI Number for Leah Gravesen is 1477191336 and holds a License No. 209020593 (Illinois).

The current practice location address for Leah Gravesen is 311 S Otter Creek Rd, Streator, IL and can be reached out via phone at 815-257-5324.

Location: 311 S Otter Creek Rd, Streator, IL, 60420-1600
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477191336
Provider Name
Leah Gravesen
Credential
Provider Entity Type
Individual
Gender
Female
Address
311 S Otter Creek Rd, Streator, IL, 60420-1600
Phone Number
815-257-5324
Fax Number
Provider Enumeration Date
12/11/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
311 S Otter Creek Rd
City
Streator
State
Illinois
Zip
61364-3117
Phone Number
815-257-5324
Fax Number
person
Provider Business Mailing Address Details
Address
311 S Otter Creek Rd
City
Streator
State
Illinois
Zip
61364-3117
Phone Number
815-257-5324
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
209020593 (Illinois)
Definition
Definition to come...
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