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NPI Code Detail

MEDICARE: VIRGINIA HEAL CNP

MEDICARE: VIRGINIA HEAL CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner209005312IL

General Provider Information

NPI Number : 1346292034
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIRGINIA HEAL CNP
Provider Business Mailing Address
First Line : 100 E LE FEVRE RD
Second Line :
City : STERLING
State : IL
Zip : 61081-1278
Country : US
Telephone Number : 815-625-0400
Fax Number : 815-625-2747
Provider Business Practice Location Address
First Line : 100 E LE FEVRE RD
Second Line :
City : STERLING
State : IL
Zip : 61081-1278
Country : US
Telephone Number : 815-625-0400
Fax Number : 815-625-2747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 07/06/2021

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Directions to “ VIRGINIA HEAL CNP” Practice Location

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