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Dietra Leigh Angelly, FNP-C
Family Nurse Practitioner in Herrin, Illinois
NPI 1902371313

Dietra Leigh Angelly is a Family Nurse Practitioner based in Herrin, IL and is specialized in Family. Dietra Leigh Angelly practices in Herrin, IL and has the professional credentials of FNP-C. The NPI Number for Dietra Leigh Angelly is 1902371313 and holds a License No. 209018044 (Illinois).

The current practice location address for Dietra Leigh Angelly is 408 Lincoln Dr Ste B, Herrin, IL and can be reached out via phone at 618-351-4980 and via fax at 618-993-8418.

Location: 408 Lincoln Dr Ste B, Herrin, IL, 62948-3790
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902371313
Provider Name
Dietra Leigh Angelly
Credential
FNP-C
Provider Entity Type
Individual
Gender
Female
Address
408 Lincoln Dr Ste B, Herrin, IL, 62948-3790
Phone Number
618-351-4980
Fax Number
618-993-8418
Provider Enumeration Date
10/11/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
408 Lincoln Dr Ste B
City
Herrin
State
Illinois
Zip
62948
Phone Number
618-351-4980
Fax Number
618-993-8418
person
Provider Business Mailing Address Details
Address
408 Lincoln Dr Ste B
City
Herrin
State
Illinois
Zip
62948
Phone Number
618-351-4980
Fax Number
618-993-8418
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
209018044 (Illinois)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
209018044 (Illinois)
Definition
Definition to come...
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