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Cassidy Boma
Family Nurse Practitioner in Champaign, Illinois
NPI 1770281610

Cassidy Boma is a Family Nurse Practitioner based in Champaign, IL and is specialized in Family. Cassidy Boma practices in Champaign, IL. The NPI Number for Cassidy Boma is 1770281610 and holds a License No. 209026208 (Illinois).

The current practice location address for Cassidy Boma is 2109 S Neil St, Champaign, IL and can be reached out via phone at 217-693-4400.

Location: 2109 S Neil St, Champaign, IL, 61820-7266
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770281610
Provider Name
Cassidy Boma
Credential
Provider Entity Type
Individual
Gender
Female
Address
2109 S Neil St, Champaign, IL, 61820-7266
Phone Number
217-693-4400
Fax Number
Provider Enumeration Date
02/20/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2109 S Neil St
City
Champaign
State
Illinois
Zip
61820-7266
Phone Number
217-693-4400
Fax Number
person
Provider Business Mailing Address Details
Address
2109 S Neil St
City
Champaign
State
Illinois
Zip
61820-7266
Phone Number
217-693-4400
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
209026208 (Illinois)
Definition
Definition to come...
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