Tietjen, Suzanne D

Tietjen, Suzanne D is an individual health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637-0001. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Tietjen, Suzanne D can be contacted via phone (309) 655-2974.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Peoria IL 61637-0001
Phone: (309) 655-2974
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 041-261586 Illinois

Profile Details

NPI number 1013173335
LBN Legal business name Tietjen, Suzanne D
Credentials BSN, NNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 6th, 2008
Last updated Aug 18th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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