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General NPI Number Information
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NPI Number | 1407198476
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Entity Type | Individual
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Provider Name | TASHA RICKERMANN VALLEE FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/18/2013
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 1915 JEFFERSON ST
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City | QUINCY
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State | IL
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Zip | 62301-5652
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Country | US
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Telephone | 217-577-2992
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Fax | 217-214-6785
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Provider Business Mailing Address
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Address Line | 1915 JEFFERSON ST
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City | QUINCY
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State | IL
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Zip | 62301-5652
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Country | US
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Telephone | 217-577-2992
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Fax | 217-214-6785
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2006019144
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License Number State | MO
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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 | 2013006672
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209010408
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 277001714
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License Number State | IL
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