Individual provider · Type 1 NPI

Retunda Jackson- Phiffer

Psychiatric/Mental Health Nurse Practitioner · Granite City, IL

NPI number 1285469148 Active

Practice location

2166 Madison Ave
Granite City, IL 62040-4700

Mailing address

201 Todd Ln
Belleville, IL 62221-5751

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X209030994 (IL)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1285469148

Retunda Jackson- Phiffer's National Provider Identifier is 1285469148, issued on Sep 2, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Granite City, IL. The record was last updated on Nov 6, 2024.