DR. SUZAN CATHLEEN SHANE-GRAY APN EDD NPI 1144525452

NPI Information

  • NPI: 1144525452
  • Provider Name: DR. SUZAN CATHLEEN SHANE-GRAY, APN, EDD
  • Classification: Clinical Nurse Specialist - 364SP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • Address: 530 NE GLEN OAK AVE
    POB 113
    PEORIA, IL
    ZIP 61637
  • Phone: (309) 224-8683

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NPI Details

DR. Suzan Cathleen Shane-gray, APN, EDD is a pediatrics clinical nurse specialist in Peoria, IL. DR. Suzan Cathleen Shane-gray, APN, EDD NPI is 1144525452. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

530 NE GLEN OAK AVE
POB 113
PEORIA, IL
ZIP 61637-001
Phone: (309) 224-8683

The enumeration date for this NPI number is 1/18/2011 and was last updated on 1/18/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1364SP0200XClinical Nurse SpecialistPediatrics209.008562ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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