Individual provider · Type 1 NPI
Jacqueline Wudtke
Acute Care Nurse Practitioner · Peoria, IL
NPI number
1780535872
Active
Practice location
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Mailing address
320 Miller Ave
Champaign, IL 61821-2444
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | 209033941 (IL) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1780535872
Jacqueline Wudtke's National Provider Identifier is 1780535872, issued on Feb 5, 2026. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Peoria, IL. The record was last updated on Feb 5, 2026.