Individual
TERESA A ALLENSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1707 N 12TH ST, QUINCY, IL 62301-1355
(217) 222-8641
(217) 222-8578
Mailing address
1707 N 12TH ST, QUINCY, IL 62301-1355
(217) 222-8641
(217) 222-8578
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209006688
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209006688
CNP LICENSE NUMBER
IL
Enumeration date
12/21/2007
Last updated
08/12/2014
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