Jennings-Porter, Elizabeth Sue

Jennings-Porter, Elizabeth Sue is an individual health care provider with primary practice located at 2220 Marquette Rd , Peru IL 61354-1538. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Jennings-Porter, Elizabeth Sue can be contacted via phone (815) 220-0260.

Contact Information

Primary practice address
2220 Marquette Rd Peru IL 61354-1538
Phone: (815) 220-0260
Fax: (815) 220-8253
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 209-000734 Illinois

Profile Details

NPI number 1114929452
LBN Legal business name Jennings-Porter, Elizabeth Sue
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Jul 8th, 2007 - about 19 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 1114929452 NPPES
Illinois Other 05032022 BLUE CROSS BLUE SHIELD

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