person
Jacqueline Deffenbaugh, APN,WHNP
Women's Health Nurse Practitioner in Bloomington, Illinois
NPI 1174535306

Jacqueline Deffenbaugh is a Women's Health Nurse Practitioner based in Bloomington, IL and is specialized in Women's Health. Jacqueline Deffenbaugh practices in Bloomington, IL and has the professional credentials of APN,WHNP. The NPI Number for Jacqueline Deffenbaugh is 1174535306 and holds a License No. 209002146 (Illinois).

The current practice location address for Jacqueline Deffenbaugh is 2304 Stern Dr, Bloomington, IL and can be reached out via phone at 309-663-0411 and via fax at 309-662-2018. You can also correspond with Jacqueline Deffenbaugh through the mailing address at 2304 STERN DR, BLOOMINGTON, IL - 61704-4487 (mailing address contact number: 309-663-0411).

Location: 2304 Stern Dr, Bloomington, IL, 61704-4487
person
Provider Profile Details
NPI Number
1174535306
Provider Name
Jacqueline Deffenbaugh
Credential
APN,WHNP
Provider Entity Type
Individual
Gender
Female
Address
2304 Stern Dr, Bloomington, IL, 61704-4487
Phone Number
309-663-0411
Fax Number
309-662-2018
Provider Enumeration Date
08/13/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
216064 01 MEDICARE GROUP PTAN
institution
Provider Business Practice Location Address Details
Address
2304 Stern Dr
City
State
Zip
61704-4487
Phone Number
309-663-0411
Fax Number
309-662-2018
person
Provider Business Mailing Address Details
Address
2304 Stern Dr
City
State
Zip
61704-4487
Phone Number
309-663-0411
Fax Number
309-662-2018
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Women's Health
Taxonomy
License No.
209002146 (Illinois)
Definition
Definition to come...
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