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PRUDENCE LOGAN ST
NPI 1457658288
in Normal, IL

Active since February 14, 2011
112 BOEYKENS PL STE 2A, NORMAL, IL 61761(309) 846-4716(309) 454-7348 Get Directions Write a Review

NPPES record last updated: February 14, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Prudence Logan St NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRUDENCE LOGAN ST (NPI 1457658288) is an individual healthcare provider in Normal, Illinois and active in the NPI registry since February 2011.

NPPES Registry Identity

NPI1457658288
Entity TypeIndividualFemale
Primary Taxonomy246ZS0400X
Provider Legal NamePRUDENCE LOGANCredential: ST
Location Address112 BOEYKENS PL STE 2ANormal, IL 61761-2152
Mailing Address112 Boeykens Pl Ste 2aNormal, IL 61761-2152 · (309) 846-4716 · Fax (309) 454-7348
Phone(309) 846-4716
Fax(309) 454-7348
Sole ProprietorYes
Enumeration DateFebruary 14, 2011
✔ NPI 1457658288 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary Specialty
Taxonomy Code246ZS0400X
112 BOEYKENS PL STE 2A, Normal, IL 61761
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARLON MINOR RSA, CSA
Specialist/Technologist, Other (Surgical Assistant)
112 BOEYKENS PL STE 2A
NORMAL, IL 61761
McLean County (309) 846-4716

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prudence Logan's NPI number?

The NPI number for Prudence Logan is 1457658288. It was assigned to this individual provider in the NPPES registry on February 14, 2011.

Where is Prudence Logan located?

Prudence Logan practices at 112 Boeykens Pl Ste 2A, Normal, IL 61761. The listed phone number is (309) 846-4716.

When was this NPI record last updated?

The NPPES record for Prudence Logan was last updated on February 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.