Individual
BRENDA COLLEEN BLICKHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-1200
Mailing address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-1200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2020011108
MO
363L00000X
Nurse Practitioner
Primary
209.020987
IL
363LA2200X
Adult Health Nurse Practitioner
2020011108
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
209.020987
IL
Other
Enumeration date
01/07/2021
Last updated
01/12/2026
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