Diefendorf, Lissa J
Diefendorf, Lissa J is an sole proprietor health care provider with primary practice located at 403 W Corrington Ave , Peoria IL 61604-2803. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Diefendorf, Lissa J can be contacted via phone (309) 222-5736.Contact Information
Primary practice address
403 W Corrington Ave
Peoria IL 61604-2803
Phone: (309) 222-5736
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 364SA2200X | 209008169 | Illinois |
Profile Details
| NPI number | 1427356336 |
|---|---|
| LBN Legal business name | Diefendorf, Lissa J |
| Credentials | Advanced Practice Nurse (APN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 2nd, 2011 |
| Last updated | Mar 2nd, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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