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Individual

ANDREW THARP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NURSE PRACTITIONER

Contact information

Practice address
1701 E COLLEGE AVE, BLOOMINGTON, IL 61704-2101
(309) 664-3120
(309) 663-5742
Mailing address
1701 E COLLEGE AVE, BLOOMINGTON, IL 61704-2101
(309) 664-3120
(309) 663-5742

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209013061
IL
363LF0000X
Family Nurse Practitioner
Primary
209013061
IL

Other

Enumeration date
05/27/2015
Last updated
01/10/2024
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