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NPI 1558864629

NPI 1558864629 : FELECIA V ERNST APN, NP-C : ALTON, IL

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General NPI Number Information
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    NPI Number           |    1558864629
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    Entity Type          |    Individual 
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    Provider Name        |    FELECIA V ERNST APN, NP-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/14/2018
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    Last Update Date     |    04/23/2021
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Provider Practice Location Address
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    Address Line         |    2 MEMORIAL DR STE 122 
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    City                 |    ALTON
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    State                |    IL
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    Zip                  |    62002-6723
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    Country              |    US
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    Telephone            |    618-465-2550
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    Fax                  |    618-465-4167
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Provider Business Mailing Address
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    Address Line         |    4 MEMORIAL DR STE 210 
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    City                 |    ALTON
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    State                |    IL
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    Zip                  |    62002-6704
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    Country              |    US
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    Telephone            |    618-463-5905
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    Fax                  |    618-465-4167
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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        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    209017341
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    License Number State |    IL
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