Healthcare Provider Details

I. General information

NPI: 1134824790
Provider Name (Legal Business Name): ANNA SZYFER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANIA SZYFER

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S 14TH ST
HERRIN IL
62948-3631
US

IV. Provider business mailing address

PO BOX 3988
CARBONDALE IL
62902-3988
US

V. Phone/Fax

Practice location:
  • Phone: 618-942-2171
  • Fax: 618-351-4917
Mailing address:
  • Phone: 618-457-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.027032
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209027032
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: