NPI 1215237987

Marvis Custer

Practitioner Clinical Nurse Specialist Bloomington, IL

Practice location

Address: 1701 E College Ave, Bloomington, IL 61704-2101
Phone: (309) 662-3000
Fax: (309) 664-3026

Registered specialties

Clinical Nurse Specialist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 364S00000X Licence 209003675 (IL)

Other Clinical Nurse Specialist providers in Illinois →

Registry record

NPI: 1215237987
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Oct 2010
Record last updated: 28 Oct 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.