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NPI Profile for DEIDRA D ANDERSON in EAST PEORIA, IL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI Number | 1083336234 |
|
| Status | Active | |
| Credentials | FNP (Family Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 09/14/2022 | |
| Last updated | 10/26/2022 - About 4 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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DEIDRA D ANDERSON
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DEIDRA D ANDERSON, FNP