Lidvall, Michelle

Lidvall, Michelle is an individual health care provider with primary practice located at 221 Ne Glen Oak Ave , Peoria IL 61636-0001. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Lidvall, Michelle can be contacted via phone (309) 672-5522.

Contact Information

Primary practice address
221 Ne Glen Oak Ave Peoria IL 61636-0001
Phone: (309) 672-5522
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 041385084 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209.011831 Illinois

Profile Details

NPI number 1659789410
LBN Legal business name Lidvall, Michelle
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2014
Last updated Dec 29th, 2014 - about 12 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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