Mrs Deidra Diane Anderson, FNP | |
133 Spinder Dr, East Peoria, IL 61611-0016 | |
(309) 308-5100 | |
Not Available |
Full Name | Mrs Deidra Diane Anderson |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 133 Spinder Dr, East Peoria, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083336234 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 209026249 (Illinois) | Primary |
Entity Name | Graham Hospital Association |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780692087 PECOS PAC ID: 2769375021 Enrollment ID: O20040510000873 |
Entity Name | Osf Multi-specialty Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
Mailing Address | Practice Location Address |
---|---|
Mrs Deidra Diane Anderson, FNP 896 Banta Rd, Lowpoint, IL 61545-7580 Ph: (309) 208-2935 | Mrs Deidra Diane Anderson, FNP 133 Spinder Dr, East Peoria, IL 61611-0016 Ph: (309) 308-5100 |
Delanie Lynn Fletcher, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 133 Spinder Dr, East Peoria, IL 61611 Phone: 309-308-5100 | |
Joshua A Larson, APRN, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 133 Spinder Dr Ste 4015, East Peoria, IL 61611 Phone: 309-308-5100 Fax: 309-308-5102 | |
Courtney Elizabeth Reubin, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 133 Spinder Dr, East Peoria, IL 61611 Phone: 309-308-5100 | |
Brittany Anne Mcgill, APRN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 133 Spinder Dr Ste 4015, East Peoria, IL 61611 Phone: 309-308-5100 Fax: 309-308-5102 | |
Mrs. Brandy J Coleman, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 133 Spinder Dr, East Peoria, IL 61611 Phone: 309-308-5100 | |
Kerri Jean Schafer, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 133 Spinder Dr, East Peoria, IL 61611 Phone: 309-308-5100 Fax: 309-308-5102 |