Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 209-001447 | IL |
NPI | 1023153863 |
---|---|
Provider Name | Mrs. Reghnald Ann Westhoff |
First Address | Quincy, IL 62301-3049 |
Second Address | Quincy, IL 62301-3049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 08/07/2007 |