Healthcare Provider Details

I. General information

NPI: 1255138848
Provider Name (Legal Business Name): HANNAH NAGLE MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2619 W HEADING AVE STE 314
WEST PEORIA IL
61604-4971
US

IV. Provider business mailing address

2619 W HEADING AVE STE 314
WEST PEORIA IL
61604-4971
US

V. Phone/Fax

Practice location:
  • Phone: 309-722-1425
  • Fax: 309-326-4705
Mailing address:
  • Phone: 309-722-1425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209031982
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209035911
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: