Individual provider · Type 1 NPI
Gloria Ann Ennenbach, RN
Child & Adolescent Psychiatric/Mental Health Registered Nurse · Freeport, IL
NPI number
1225544901
Active
Practice location
701 W Lamm Rd
Freeport, IL 61032-9630
Fax (815) 233-6167
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Child & Adolescent Psychiatric/Mental Health Registered Nurse Primary | 163WP0807X | 041-332750 (IL) |
Child & Adolescent Psychiatric/Mental Health Registered Nurse: Definition to come...
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About NPI 1225544901
Gloria Ann Ennenbach, RN's National Provider Identifier is 1225544901, issued on Dec 18, 2017. The primary taxonomy on file is Child & Adolescent Psychiatric/Mental Health Registered Nurse (163WP0807X), and the practice location is in Freeport, IL. The record was last updated on Dec 18, 2017.