Individual provider · Type 1 NPI

Tamarra Lynn Subyantoro, APN

Family Nurse Practitioner · Peoria, IL

NPI number 1942842018 Active

Practice location

5114 N Glen Park Place Rd Ste 110
Peoria, IL 61614-4686

Call (309) 683-5600 Map

Fax (309) 683-5607

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X209019900 (IL)
Nurse Practitioner 363L00000X209019900 (IL)

Family Nurse Practitioner: Definition to come...

4 other providers at this address

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About NPI 1942842018

Tamarra Lynn Subyantoro, APN's National Provider Identifier is 1942842018, issued on Oct 10, 2019. 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 27, 2024.