Individual
CASEY WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
6339 N BIG HOLLOW RD, PEORIA, IL 61615-2907
(309) 693-3315
(309) 693-9385
Mailing address
298 CHIPPEWA CT, SPARLAND, IL 61565-9401
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209028235
IL
Other
Enumeration date
09/07/2023
Last updated
07/03/2025
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