Provider Demographics
NPI:1093071581
Name:NAILOR, JEANNE HEATHER (APN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:HEATHER
Last Name:NAILOR
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 WEST 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:ROCK FALLS
Mailing Address - State:IL
Mailing Address - Zip Code:61071
Mailing Address - Country:US
Mailing Address - Phone:815-626-2230
Mailing Address - Fax:815-535-0692
Practice Address - Street 1:1300 W 2ND ST
Practice Address - Street 2:
Practice Address - City:ROCK FALLS
Practice Address - State:IL
Practice Address - Zip Code:61071-1005
Practice Address - Country:US
Practice Address - Phone:815-626-2230
Practice Address - Fax:815-535-0692
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277000081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL277000081OtherADVANCE PRACTICE NURSING LICENSE
IL209009494OtherADVANCED PRACTICE NURSING LICENSE