REJUVANATION NPI 1629213814

NPI Information

NPI: 1629213814
Provider Name: REJUVANATION
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
11 CURRENCY DR
BLOOMINGTON, IL
ZIP 61704
Phone: (309) 678-4243
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REJUVANATION is a family nurse practitioner in Bloomington, IL. REJUVANATION NPI is 1629213814. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11 CURRENCY DR
BLOOMINGTON, IL
ZIP 61704-398
Phone: (309) 678-4243

The provider's authorized official is Shawn C Snider .
The authorized official title is Cnp and has the following contact phone number (309) 278-0566.

The enumeration date for this NPI number is 12/2/2008 and was last updated on 12/2/2008.

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
1	363LF0000X	Nurse Practitioner	Family	209005824	ILLINOIS	Yes

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: 11/14/2023

NPI Synchronization or Removal

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