MEDICARE: JANICE E LEVSEN FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209006266	IL

General Provider Information

NPI Number	:	1609920636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE E LEVSEN FNP

Provider Business Mailing Address
First Line	:	865 LINCOLN RD
Second Line	:	SUITE L19
City	:	BETTENDORF
State	:	IA
Zip	:	52722-4190
Country	:	US
Telephone Number	:	563-355-9200
Fax Number	:	563-355-3419

Provider Business Practice Location Address
First Line	:	2560 24TH ST
Second Line	:	SUITE 202
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-5357
Country	:	US
Telephone Number	:	309-281-2800
Fax Number	:	309-281-2809

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	04/29/2015

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