Provider Demographics
NPI:1447759527
Name:CURTIS, DANECE LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:DANECE
Middle Name:LYNN
Last Name:CURTIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25431 TAMMS OLIVE BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:TAMMS
Mailing Address - State:IL
Mailing Address - Zip Code:62988-3215
Mailing Address - Country:US
Mailing Address - Phone:573-270-2366
Mailing Address - Fax:
Practice Address - Street 1:426 S BLANCHE ST
Practice Address - Street 2:
Practice Address - City:MOUNDS
Practice Address - State:IL
Practice Address - Zip Code:62964-1108
Practice Address - Country:US
Practice Address - Phone:618-745-6894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209017228363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner