National Provider Identifier Database

DEIDRA D ANDERSON, FNP – NPI #1083336234
Family


Contact Information

DEIDRA D ANDERSON, FNP
133 SPINDER DR
EAST PEORIA, IL61611-0016
Phone: 309-308-5100
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for DEIDRA D ANDERSON

NPI Number 1083336234
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 09/14/2022
Last updated 10/26/2022 - About 4 years ago
Sole proprietor1 No
Identifiers
  • IL License #: 209026249
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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