Provider Demographics
NPI:1205480126
Name:FORREST AND ASSOCIATES PLLC
Entity type:Organization
Organization Name:FORREST AND ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARIKA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FORREST
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:618-641-9142
Mailing Address - Street 1:140 IOWA AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-3940
Mailing Address - Country:US
Mailing Address - Phone:618-641-9142
Mailing Address - Fax:618-641-9144
Practice Address - Street 1:140 IOWA AVE STE 210
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-3940
Practice Address - Country:US
Practice Address - Phone:618-641-9142
Practice Address - Fax:618-641-9144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty