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General NPI Number Information
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NPI Number | 1265943591
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Entity Type | Individual
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Provider Name | AMY MARIE QUERTERMOUS APN-BC
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Gender | Female
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Dates
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Enumeration Date | 10/13/2017
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 716 S COMMERCIAL ST
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City | HARRISBURG
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State | IL
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Zip | 62946-2346
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Country | US
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Telephone | 618-294-8241
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Fax | 618-294-8212
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Provider Business Mailing Address
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Address Line | 716 S COMMERCIAL ST
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City | HARRISBURG
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State | IL
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Zip | 62946-2346
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Country | US
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Telephone | 618-294-8264
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 209016743
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209016743
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209016743
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License Number State | IL
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