Individual
JAILSON S NASCIMENTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, CNS
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 642-8818
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209017468
IL
363LP2300X
Primary Care Nurse Practitioner
209017468
IL
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
209008150
IL
Other
Enumeration date
05/07/2010
Last updated
08/13/2025
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