JESSICA ELIZABETH ALTHIDE


Address: 927 Broadway St Ste G31, Quincy, IL 62301-2724
Phone: 2172285535

JESSICA ELIZABETH ALTHIDE (NPI# 1366960130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366960130
Entity Type Individual
Full Name JESSICA ELIZABETH ALTHIDE
Credential APRN, FNP-C
Practice Address 927 Broadway St Ste G31
Quincy
IL 62301-2724
Mailing Address 927 Broadway St
Quincy
IL 62301-2719
Practice Telephone 2172285535
Mailing Telephone 2172285535
Enumeration Date 2017-08-31
Last Update Date 2018-12-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
209.016240 IL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
AANP CERTIFICATION NUMBER F06170525 01
IL ADVANCE PRACTICE CONTROLLED SUBSTANCE LICENSE 309.011747 01
IL REGISTERED PROFESSIONAL NURSE LICENSE NUMBER 041.385787 01

Office Location

Street Address 927 BROADWAY ST STE G31
City QUINCY
State IL
Zip Code 62301-2724

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1194255083 Michael Andrew Behrens Nurse Practitioner Broadway and 11th Street, Quincy, IL 62301 2017-06-14
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053910257 Lauren Michele Flynn Nurse Practitioner 173 Sumner St, Quincy, MA 02169-7003 2020-10-20
1447867601 Caitlin Lynch Nurse Practitioner 41 Pilgrim Rd, Quincy, MA 02169-1210 2020-09-30
1881202380 Julie Ann Dorgan Nurse Practitioner 11 Lee St, Quincy, MA 02169-2830 2020-07-21
1386265551 Alexis Schantz Nurse Practitioner 4800 Maine St Ste 48-108, Quincy, IL 62305-5875 2020-04-29
1346884459 Laurie Ann Bohne Nurse Practitioner 1229 Spring Lake Rd, Quincy, IL 62305-7763 2019-10-31
1497305486 Kristina Anele Jarvis Nurse Practitioner 2 Hancock St Apt 208, Quincy, MA 02171-1760 2019-09-12
1699330399 Amanda Hubner Nurse Practitioner 1707 N 12th St Bldg 29m, Quincy, IL 62301-1355 2019-05-08
1356813398 Deann L Isherwood Nurse Practitioner 1250 Hancock St Fl 3, Quincy, MA 02169-4339 2018-12-31
1952813073 Bing Xiao Nurse Practitioner 142 Quincy Shore Dr Unit 152, Quincy, MA 02171-2924 2017-10-30
1194255083 Michael Andrew Behrens Nurse Practitioner Broadway and 11th Street, Quincy, IL 62301 2017-06-14
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Competitor

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City QUINCY
Zip Code 62301

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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