Jeanette Marie Edie, CNS APRN CWOCN CFC
Individual provider Active NPI Clinical Nurse Specialist · Roscoe, IL
NPI 1245210285 · NPPES record last updated Apr 28, 2014
Key facts
- NPI
- 1245210285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Nurse Specialist 364S00000X
- License
- 209003232 (IL)
- Practice address
- 5979 Southdown LN
Roscoe, IL 61073-8375 - Phone
- (815) 871-4747
- NPI assigned
- Jan 17, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209003232 | IL | MD | Clinical Nurse Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 209003232 | IL | Yes |
Addresses
Primary practice location
5979 Southdown LN
Roscoe, IL 61073-8375
Mailing address
5979 Southdown LN
Roscoe, IL 61073-8375
Phone (815) 871-4747
Other providers in Roscoe, IL
- Double T Medical Transport
- Nathan Dufoe
- Matthew C Dziarski
- East West Chiropractic Health Center LTD
- Daniel Eberdt
- Tyler Christian Ege
- Emil Mommers P.C.
- Joshua Entenman
- Shaghayegh Esfandnia
- Janice Marian Ethington
All providers in Roscoe, IL · Clinical Nurse Specialist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.