Individual
JENNIFER CHRISTINE ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, PMHNP
Contact information
Practice address
2511 N MAIN ST, EAST PEORIA, IL 61611-1783
(309) 670-0459
(309) 670-0416
Mailing address
2511 N MAIN ST, EAST PEORIA, IL 61611-1783
(309) 670-0459
(309) 670-0416
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
277002366
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
277002366
FULL PRACTICE AUTHORITY LICENSE
—
01
—
377002279
FULL PRACTICE AUTHORITY CS LICENSE
—
Enumeration date
06/02/2017
Last updated
02/14/2023
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