Individual
TYLER DANIEL WHITNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, APRN, ACNP-AG
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-2386
Mailing address
10116 N BROOKSHIRE DR, PEORIA, IL 61615-6404
(309) 267-2465
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209.028088
IL
363LA2100X
Acute Care Nurse Practitioner
Primary
209.028088
IL
363LA2100X
Acute Care Nurse Practitioner
209028088
IL
363LC0200X
Critical Care Medicine Nurse Practitioner
209.028088
IL
Other
Enumeration date
08/16/2023
Last updated
10/11/2023
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