Most Relevant Information
Provider Data
| NPI Number: | 1003640434 |
| Provider Name: | DANIELLE DEISHER |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209.030387 |
Most Important Dates
| Enumeration Date: | 08/28/2024 |
| Last Updated: | 08/29/2024 |
Provider Practice Location
2101 JAMES ST
LAWRENCEVILLE
IL
624392027
Practice Location Phone/Fax
| Phone: | 6189433302 |
| Fax: |
Provider Mailing Location
2101 JAMES ST
LAWRENCEVILLE
IL
624392027
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |