Healthcare Provider Details

I. General information

NPI: 1356915599
Provider Name (Legal Business Name): BRITTANY ANNE MCGILL APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY ANNE BEARD

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 SPINDER DR STE 4015
EAST PEORIA IL
61611-0016
US

IV. Provider business mailing address

133 SPINDER DR STE 4015
EAST PEORIA IL
61611-0016
US

V. Phone/Fax

Practice location:
  • Phone: 309-308-5100
  • Fax: 309-308-5102
Mailing address:
  • Phone: 309-308-5100
  • Fax: 309-308-5102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209023019
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: