Individual
ANDREA PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-C
Contact information
Practice address
319 E MADISON ST STE 1F, SPRINGFIELD, IL 62701-3118
(217) 545-8000
Mailing address
520 N 4TH ST, PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
(217) 747-1351
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
209014692
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209014692
IL
363LP2300X
Primary Care Nurse Practitioner
209014692
IL
Other
Enumeration date
10/04/2016
Last updated
02/09/2023
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