Individual
DIANA WARNECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, CPNP
Contact information
Practice address
420 NE GLEN OAK AVE, STE 401, PEORIA, IL 61603-3105
(309) 624-9844
(309) 624-8884
Mailing address
114 MIROMAR LN, WASHINGTON, IL 61571-4020
(309) 258-2555
(309) 624-8884
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209010353
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376000511
—
IL
Enumeration date
06/07/2013
Last updated
06/07/2013
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