Individual
MRS. ANDREA CELESTE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
221 NE GLEN OAK AVE, LABOR AND DELIVERY, PEORIA, IL 61636-0001
(309) 241-6898
Mailing address
14150 N LAKE WINDERMERE RD, TREMONT, IL 61568-9287
(309) 214-1382
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209023881
IL
Other
Enumeration date
05/14/2022
Last updated
05/14/2022
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