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General NPI Number Information
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NPI Number | 1235413972
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Entity Type | Individual
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Provider Name | NATHALIE DIEUDONNE ACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 611 W. PARK ST. CRITICAL CARE
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City | URBANA
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State | IL
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Zip | 61801-2500
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Country | US
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Telephone | 217-383-3087
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Fax |
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Provider Business Mailing Address
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Address Line | 611 W. PARK ST. BWPC
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City | URBANA
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State | IL
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Zip | 61801-2500
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Country | US
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Telephone | 217-383-6941
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP011625
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 5008477
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209015960
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License Number State | IL
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