Gonzalez, Jennifer L

Gonzalez, Jennifer L is an individual health care provider with primary practice located at 200 E Pennsylvania Ave , Peoria IL 61603-3089. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Gonzalez, Jennifer L can be contacted via phone (309) 655-2045.

Contact Information

Primary practice address
200 E Pennsylvania Ave Peoria IL 61603-3089
Phone: (309) 655-2045
Fax: (309) 655-2057
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 041309807 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209-008074 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 209-003998 Illinois

Profile Details

NPI number 1982933974
LBN Legal business name Gonzalez, Jennifer L
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2009
Last updated Jul 21st, 2022 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1982933974 NPPES
Illinois Other 809840 MEDICARE GROUP NUMBER

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