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General NPI Number Information
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NPI Number | 1699174060
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Entity Type | Individual
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Provider Name | MICHELE L BRITVEC
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Gender | Female
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 08/11/2024
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Provider Practice Location Address
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Address Line | 530 NE GLEN OAK AVE
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City | PEORIA
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State | IL
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Zip | 61637-4319
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Country | US
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Telephone | 309-624-8829
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Fax | 309-624-4333
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Provider Business Mailing Address
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Address Line | 204 BERGMAN AVE
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City | EAST PEORIA
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State | IL
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Zip | 61611-4319
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Country | US
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Telephone | 309-208-6704
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 277-002679
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License Number State | IL
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