Individual
ANN M WILLEMSEN-DUNLAP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8600 STATE ROUTE 91 STE 250, PEORIA, IL 61615-7831
(309) 692-5394
(309) 692-2538
Mailing address
8600 STATE ROUTE 91 STE 250, PEORIA, IL 61615-7831
(309) 692-5394
(309) 692-2538
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D079522
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0172700
—
IA
01
—
44812
WELLMARK BCBS
IA
Enumeration date
09/23/2005
Last updated
05/30/2013
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