Individual
MRS. JEAN ELLEN STRAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
50 NORTHGATE INDUSTRIAL DR, GRANITE CITY, IL 62040
(618) 877-4420
Mailing address
50 NORTHGATE INDUSTRIAL DR, GRANITE CITY, IL 62040-6805
(618) 877-4420
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
309.003146
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209-005871
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
309.003146
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041.214555
STATE LICENSURE- RN
IL
01
—
209.005871
STATE LICENSURE
IL
01
—
309.003146
LICENSE WITH CONTROLLED SUBSTANCE
IL
Enumeration date
02/09/2007
Last updated
03/07/2023
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