Individual
AMBER WOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
507 E ARMSTRONG AVE, PEORIA, IL 61603-3201
(309) 681-6960
Mailing address
507 E ARMSTRONG AVE, PEORIA, IL 61603-3201
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
041.411854
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
022010
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.022010
IL
Other
Enumeration date
08/28/2018
Last updated
11/11/2021
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