PUNAM SUBHASHCHANDRA TRIVEDE

PEORIA, IL
NPI1790258473
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209018588)
Additional Taxonomies363LA2200X Nurse Practitioner, Adult Health
(Licence: IL  209018588)
Enumeration Date2019-01-06
Last Update Date2023-07-06
Business Address
PUNAM SUBHASHCHANDRA TRIVEDE APN
711 W JOHN GWYNN AVE
PEORIA, IL 61605-2270
Phone number: 309-680-7600
Mailing Address
PUNAM SUBHASHCHANDRA TRIVEDE APN
2214 N UNIVERSITY ST
PEORIA, IL 61604-3221
Phone number: 309-680-7600