Tanya A Durrer, RN
Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Waterloo, IL
NPI 1720124258 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720124258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Registered Nurse 163WP0808X
- Practice address
- 988 N Illinois Route 3
Waterloo, IL 62298-1000 - Phone
- (618) 939-4444
- Fax
- (618) 939-4181
- NPI assigned
- Jan 30, 2007
- 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)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041285148 | IL | MD | Psychiatric/Mental Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | IL | Yes |
Addresses
Primary practice location
988 N Illinois Route 3
Waterloo, IL 62298-1000
Mailing address
618 Mark Dr
Waterloo, IL 62298-1487
Phone (618) 939-2935
Other providers in Waterloo, IL
- Evelyn Duffin
- Anneleyce Dunlop
- Melissa Dunn
- Breanne Lee Dunsworth
- Veronica Durdello
- Jennilee Dycus
- Nicole Ehrenstrom
- Empower U Counseling, LLC
- Essential Healthcare, LLC
- Jennifer Rebecca Evans
All providers in Waterloo, IL · Psychiatric/Mental Health Registered Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.