Healthcare Provider Details
I. General information
NPI: 1073400701
Provider Name (Legal Business Name): LEGAL NP CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 CADILLAC CT STE 6
BELVIDERE IL
61008-1733
US
IV. Provider business mailing address
205 CADILLAC CT STE 6
BELVIDERE IL
61008-1733
US
V. Phone/Fax
- Phone: 815-494-8459
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MEGAN
JOHNSON
Title or Position: OWNER
Credential:
Phone: 815-494-8459