DIANA WARNECKE (NPI# 1396183687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396183687 |
| Entity Type | Individual |
| Full Name | DIANA WARNECKE |
| Credential | APN, CPNP |
| Practice Address |
420 Ne Glen Oak Ave Ste 401 Peoria IL 61603-3105 |
| Mailing Address |
114 Miromar Ln Washington IL 61571-4020 |
| Practice Telephone | 3096249844 |
| Practice Fax Number | 3096248884 |
| Mailing Telephone | 3092582555 |
| Mailing Fax Number | 3096248884 |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2013-06-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
209010353 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 376000511 | 05 |
| Street Address |
420 NE GLEN OAK AVE STE 401 |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427057595 | David P Chan | Pediatrics | 420 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2005-07-20 |
| 1164062196 | Tiara J Mullen | Nurse Practitioner | 420 Ne Glen Oak Ave, Peoria, IL 61603-3106 | 2020-01-07 |
| 1700308996 | Amanda Matthews | Nurse Practitioner | 420 Ne Glen Oak Ave, Peoria, IL 61603 | 2017-07-10 |
| 1871026450 | Shari S Mulvey | Pediatrics | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 | 2017-04-10 |
| 1003268897 | Sandra L. Peach | Nurse Practitioner | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 | 2016-07-06 |
| 1083062285 | Heather A Boore | Clinical Nurse Specialist | 420 Ne Glen Oak Ave, Suite 401, Peoria, IL 61603 | 2016-05-27 |
| 1336546969 | Jennifer A. Nelson | Nurse Practitioner | 420 Ne Glen Oak Ave, Suite 201, Peoria, IL 61603-3105 | 2014-11-25 |
| 1003219932 | Linda Schmidgall | Nurse Practitioner | 420 Ne Glen Oak Ave, Suite 200, Peoria, IL 61603-3105 | 2014-10-07 |
| 1164839692 | Gregory Puszkiewicz | Pharmacist | 420 Ne Glen Oak Ave, Peoria, IL 61603-3105 | 2014-07-16 |
| 1386081792 | Children's Hospital of Illinois Medical Group | Pediatrics | 420 Ne Glen Oak Ave, Ste 301, Peoria, IL 61603-3105 | 2013-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851721252 | Sarah Peterson | Nurse Practitioner | 2727 W Krause Ave, Unitypoint Health, In School Health At Harrison School, Peoria, IL 61605-2906 | 2013-11-21 |
| 1184696544 | Barbara L Johnston | Nurse Practitioner | 2338 N. Van Winkle Way, Suite 2200, Peoria, IL 61615 | 2006-02-01 |
| 1477189025 | Claudia Plumer | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-03-16 |
| 1972931640 | Manju Thomson | Nurse Practitioner | 10200 W Happy Valley Rd, Suite 125, Peoria, AZ 85383-2878 | 2013-10-16 |
| 1801162854 | Valley of The Sun Pediatrics, P.C. | Nurse Practitioner | 10200 W Happy Valley Rd, Ste 125, Peoria, AZ 85383-2878 | 2012-03-23 |
| 1972837003 | Monica Greenwald Dohrman | Nurse Practitioner | 7707 W Deer Valley Rd, Peoria, AZ 85382-2101 | 2009-09-22 |
| 1174772552 | Kristin A Kang | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2008-09-10 |
| 1932201795 | Patti Jo Peterson-balliet | Nurse Practitioner | 9059 W Lake Pleasant Pkwy, E-540, Peoria, AZ 85382-8336 | 2006-09-02 |
| 1679516561 | Melinda Henderson | Nurse Practitioner | 7801 N Knoxville Ave, Peoria, IL 61614-2076 | 2006-06-14 |
| 1699740902 | Kathryn Gensel | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Dept. of Pediatrics, Peoria, IL 61603-3168 | 2006-02-21 |
| Find all providers in PEORIA | ||||
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| 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.