Individual
JESSICA SCHLUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
900 MAIN ST STE 210, PEORIA, IL 61602-5005
(309) 672-4582
Mailing address
900 MAIN ST STE 210, PEORIA, IL 61602-5005
(309) 672-4582
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209017528
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209017528
LICENSE
IL
Enumeration date
05/03/2018
Last updated
05/03/2018
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