Healthcare Provider Details

I. General information

NPI: 1336910140
Provider Name (Legal Business Name): ANNA ESLICK APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA MESSEROLE

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 BROADWAY ST
QUINCY IL
62301-2719
US

IV. Provider business mailing address

1005 BROADWAY ST
QUINCY IL
62301-2834
US

V. Phone/Fax

Practice location:
  • Phone: 217-214-3424
  • Fax: 217-221-1344
Mailing address:
  • Phone: 217-214-3424
  • Fax: 217-221-1344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209033528
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number14332
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: