Provider Demographics
NPI:1396310645
Name:ACHEBE, ANENE (APRN,CNP)
Entity type:Individual
Prefix:
First Name:ANENE
Middle Name:
Last Name:ACHEBE
Suffix:
Gender:F
Credentials:APRN,CNP
Other - Prefix:
Other - First Name:ANENE
Other - Middle Name:
Other - Last Name:NNAJIEGO-ACHEBE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6815 N TREADWAY CT
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-1072
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7317 N WILLOW LAKE CT
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-8227
Practice Address - Country:US
Practice Address - Phone:309-683-7373
Practice Address - Fax:309-691-4408
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.023056363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health