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Mrs. Bonnie Jean Coburn, NP
Family Nurse Practitioner in Decatur, Illinois
NPI 1720165103

Bonnie Jean Coburn is a Family Nurse Practitioner based in Decatur, IL and is specialized in Family. Bonnie Jean Coburn practices in Decatur, IL and has the professional credentials of NP. The NPI Number for Bonnie Jean Coburn is 1720165103 and holds a License No. 209006142 (Illinois).

The current practice location address for Bonnie Jean Coburn is 4455 E Us Route 36, Decatur, IL and can be reached out via phone at 217-588-2600. You can also correspond with Bonnie Jean Coburn through the mailing address at 2300 N EDWARD ST STE 6102, DECATUR, IL - 62526-4163 (mailing address contact number: 217-876-6456).

Location: 4455 E Us Route 36, Decatur, IL, 62526-4163
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1720165103
Provider Name
Bonnie Jean Coburn
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
4455 E Us Route 36, Decatur, IL, 62526-4163
Phone Number
217-588-2600
Fax Number
Provider Enumeration Date
11/01/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
041292879 05 IL
036102377 1 05 IL
433990 01 IL MEDICARE GROUP
1497762959 1 05 IL
P00678744 01 IL RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
4455 E Us Route 36
City
Decatur
State
Illinois
Zip
62521-5003
Phone Number
217-588-2600
Fax Number
person
Provider Business Mailing Address Details
Address
2300 N Edward St Ste 6102
City
Decatur
State
Illinois
Zip
62526-4163
Phone Number
217-876-6456
Fax Number
217-876-6485
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
277000529 (Illinois)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
209006142 (Illinois)
Definition
Definition to come...
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