Logan Primary Care
Primary Care Nurse Practitioner · Herrin, IL
Practice location
405 Rushing DrHerrin, IL 62948-3730
- Phone
- (618) 993-3300
- Fax
- (618) 932-3797
NPI record
- NPI
- 1902094352
- Entity type
- Organization (Type 2)
- Enumeration date
- October 11, 2007
- Last updated
- October 11, 2007
- Organization subpart
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X |
— | IL |
Mailing address
502 E Saint Louis StWest Frankfort, IL 62896-1346
- Phone
- (618) 993-3300
- Fax
- (618) 932-3797
Authorized official
- Name
- Mrs. Tara G Deaton
- Title
- Administrator
- Phone
- (618) 997-3400
About Logan Primary Care
Logan Primary Care is a healthcare organization registered in the NPI registry with the primary taxonomy Primary Care Nurse Practitioner (code 363LP2300X). The practice location is 405 Rushing Dr, Herrin, IL 62948-3730. The NPI number 1902094352 was assigned on October 11, 2007 and the record was last updated on October 11, 2007.
The authorized official for this organization is Mrs. Tara G Deaton, Administrator.
Frequently asked questions
What is the NPI number of Logan Primary Care?
The NPI number is 1902094352.
What is the phone number of Logan Primary Care?
The phone number listed for the practice location is (618) 993-3300.
Where is Logan Primary Care located?
405 Rushing Dr, Herrin, IL 62948-3730.
What is the taxonomy code for Logan Primary Care?
The primary taxonomy code is 363LP2300X – Primary Care Nurse Practitioner.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.