Individual provider · Type 1 NPI

Sandy Northcutt

Family Nurse Practitioner · Peoria, IL

NPI number 1174209704 Active

Practice location

124 SW Adams St
Peoria, IL 61602-1308

Mailing address

252 N 45th Rd
Mendota, IL 61342-9427

Specialties and licenses

TaxonomyCodeLicense
Medical-Surgical Registered Nurse 163WM0705X041.310284 (IL)
Family Nurse Practitioner Primary 363LF0000X209.028107 (IL)

Family Nurse Practitioner: Definition to come...

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About NPI 1174209704

Sandy Northcutt's National Provider Identifier is 1174209704, issued on Jun 27, 2023. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Peoria, IL. The record was last updated on Sep 22, 2023.