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Punam Subhashchandra Trivede, APN
Family Nurse Practitioner in Peoria, Illinois
NPI 1790258473

Punam Subhashchandra Trivede is a Family Nurse Practitioner based in Peoria, IL and is specialized in Family. Punam Subhashchandra Trivede practices in Peoria, IL and has the professional credentials of APN. The NPI Number for Punam Subhashchandra Trivede is 1790258473 and holds a License No. 209018588 (Illinois).

The current practice location address for Punam Subhashchandra Trivede is 711 W John Gwynn Ave, Peoria, IL and can be reached out via phone at 309-680-7600 and via fax at 309-671-2188.

Location: 711 W John Gwynn Ave, Peoria, IL, 61604-3221
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Provider Profile Details
NPI Number
1790258473
Provider Name
Punam Subhashchandra Trivede
Credential
APN
Provider Entity Type
Individual
Gender
Female
Address
711 W John Gwynn Ave, Peoria, IL, 61604-3221
Phone Number
309-680-7600
Fax Number
309-671-2188
Provider Enumeration Date
01/06/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
209018588 05 IL
institution
Provider Business Practice Location Address Details
Address
711 W John Gwynn Ave
City
State
Zip
61605-2270
Phone Number
309-680-7600
Fax Number
309-671-2188
person
Provider Business Mailing Address Details
Address
711 W John Gwynn Ave
City
State
Zip
61605-2270
Phone Number
309-680-7600
Fax Number
309-671-2188
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
209018588 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
209018588 (Illinois)
Definition
Definition to come...
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