Healthcare Provider Details

I. General information

NPI: 1578074506
Provider Name (Legal Business Name): NICOLE DAWN ALMEIDA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2017
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 EASTLAND DR
BLOOMINGTON IL
61701-3552
US

IV. Provider business mailing address

101 W UNIVERSITY AVE
CHAMPAIGN IL
61820-3909
US

V. Phone/Fax

Practice location:
  • Phone: 309-661-3383
  • Fax: 217-366-6154
Mailing address:
  • Phone: 217-366-1200
  • Fax: 217-366-8012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209016178
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: