Individual
LAURA JARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8914 N KNOXVILLE AVE, PEORIA, IL 61615-1410
(309) 691-9110
Mailing address
8914 N KNOXVILLE AVE, PEORIA, IL 61615-1410
(309) 691-9110
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209016505
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209016505
LICENSE
IL
Enumeration date
09/08/2017
Last updated
07/21/2022
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