Individual
AMY CYRUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
12 N 64TH ST, BELLEVILLE, IL 62223-3809
(618) 877-4420
Mailing address
448 WYLIE DR STE 100, NORMAL, IL 61761-5405
(618) 512-1803
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
4704312611
MI
363LF0000X
Family Nurse Practitioner
Primary
209.012867
IL
Other
Enumeration date
09/20/2014
Last updated
12/23/2021
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