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Susannah Nicholson Dintzis, FNP
Family Nurse Practitioner in Peoria, Illinois
NPI 1902848153

Susannah Nicholson Dintzis is a Family Nurse Practitioner based in Peoria, IL and is specialized in Family. Susannah Nicholson Dintzis practices in Peoria, IL and has the professional credentials of FNP. The NPI Number for Susannah Nicholson Dintzis is 1902848153 and holds a License No. 041283996 (Illinois).

The current practice location address for Susannah Nicholson Dintzis is 2321 N Wisconsin Ave, Peoria, IL and can be reached out via phone at 309-680-7600 and via fax at 309-681-4681.

Location: 2321 N Wisconsin Ave, Peoria, IL, 61604-3221
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Provider Profile Details
NPI Number
1902848153
Provider Name
Susannah Nicholson Dintzis
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
2321 N Wisconsin Ave, Peoria, IL, 61604-3221
Phone Number
309-680-7600
Fax Number
309-681-4681
Provider Enumeration Date
06/12/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7215059 01 IL BCBS PPO
institution
Provider Business Practice Location Address Details
Address
2321 N Wisconsin Ave
City
State
Zip
61603-5613
Phone Number
309-680-7600
Fax Number
309-681-4681
person
Provider Business Mailing Address Details
Address
2321 N Wisconsin Ave
City
State
Zip
61603-5613
Phone Number
309-680-7600
Fax Number
309-681-4681
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
209-002547 (Illinois)
Definition
Definition to come...
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Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
License No.
041283996 (Illinois)
Definition
Definition to come...
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