Individual provider Active NPI

Haley Nicole Vandrew

  • Community Health/Public Health Clinical Nurse Specialist
  • Freeport, IL
National Provider Identifier
1538768718
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health/Public Health Clinical Nurse SpecialistTaxonomy code 364SC1501X
License
041467298 Issued in IL
Practice address
421 W Exchange St
Freeport, IL 61032-4008
Phone
(815) 599-7300
NPI assigned
Oct 20, 2020
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health/Public Health Clinical Nurse Specialist 364SC1501X 041467298 IL Primary

Addresses

Primary practice location

421 W Exchange St
Freeport, IL 61032-4008

Mailing address

PO Box 813
Freeport, IL 61032-0813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041467298ILMDCommunity Health/Public Health Clinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1538768718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 813",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610320813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W EXCHANGE ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324008",
            "telephone_number": "815-599-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDREW",
        "first_name": "HALEY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC1501X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Community Health/Public Health",
            "state": "IL",
            "license": "041467298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.