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Tamarra Lynn Subyantoro, APN
Nurse Practitioner in Peoria, Illinois
NPI 1942842018

Tamarra Lynn Subyantoro is a Nurse Practitioner based in Peoria, IL. Tamarra Lynn Subyantoro practices in Peoria, IL and has the professional credentials of APN. The NPI Number for Tamarra Lynn Subyantoro is 1942842018 and holds a License No. 209019900 (Illinois).

The current practice location address for Tamarra Lynn Subyantoro is 5114 N Glen Park Place Rd Ste 110, Peoria, IL and can be reached out via phone at 309-683-5600 and via fax at 309-683-5607. You can also correspond with Tamarra Lynn Subyantoro through the mailing address at 5114 N GLEN PARK PLACE RD STE 110, PEORIA, IL - 61614-4686 (mailing address contact number: 309-683-5600).

Location: 5114 N Glen Park Place Rd Ste 110, Peoria, IL, 61614-4686
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1942842018
Provider Name
Tamarra Lynn Subyantoro
Credential
APN
Provider Entity Type
Individual
Gender
Female
Address
5114 N Glen Park Place Rd Ste 110, Peoria, IL, 61614-4686
Phone Number
309-683-5600
Fax Number
309-683-5607
Provider Enumeration Date
10/10/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5114 N Glen Park Place Rd Ste 110
City
Peoria
State
Illinois
Zip
61614-4686
Phone Number
309-683-5600
Fax Number
309-683-5607
person
Provider Business Mailing Address Details
Address
5114 N Glen Park Place Rd Ste 110
City
Peoria
State
Illinois
Zip
61614-4686
Phone Number
309-683-5600
Fax Number
309-683-5607
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
209019900 (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.
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