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Individual

BRYNN N CINNAMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN/CNP

Contact information

Practice address
1001 MAIN ST, SUITE 500A, PEORIA, IL 61606-1907
(309) 672-4980
(309) 671-2944
Mailing address
1001 MAIN ST, SUITE 500A, PEORIA, IL 61606-1907
(309) 672-4980
(309) 671-2944

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.331106
IL
363L00000X
Nurse Practitioner
Primary
209.007447
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37-1221637
FEIN
IL
Enumeration date
05/08/2009
Last updated
05/08/2009
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