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NPI Code Detail

MEDICARE: MS. ERIN BRIGID ALCAZAR FNP

MEDICARE: MS. ERIN BRIGID ALCAZAR FNP
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
1363LF0000XFamily Nurse Practitioner2013000997MO
2363LF0000XFamily Nurse Practitioner209013690IL

General Provider Information

NPI Number : 1457698607
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ERIN BRIGID ALCAZAR FNP
Provider Business Mailing Address
First Line : 509 HAMACHER STREET
Second Line : SUITE 103
City : WATERLOO
State : IL
Zip : 62298
Country : US
Telephone Number : 618-939-3939
Fax Number : 618-939-0234
Provider Business Practice Location Address
First Line : 2420 STATE ST
Second Line :
City : EAST SAINT LOUIS
State : IL
Zip : 62205-2321
Country : US
Telephone Number : 618-318-8809
Fax Number : 618-615-4205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2013
Last Update Date : 03/22/2023

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