IndividualActive
Marissa Myres, APRN,CNS
NPI 1073917258 · Gerontology Clinical Nurse Specialist · Peoria, IL
Provider details
- NPI number
- 1073917258
- Entity type
- Individual
- Primary specialty
- Gerontology Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APRN,CNS
- Sex
- Female
- Sole proprietor
- No
- License
- 041.385496 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Nursing Service Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3308 W Chartwell Rd
Peoria, IL 61614-2322
Phone: (309) 691-7640
Fax: (309) 691-7643
Approximate (ZIP-level) locationGet directions
Mailing address
3308 W Chartwell Rd
Peoria, IL 61614-2322
Registry dates
- Enumerated
- 2014-10-16
- Last updated
- 2024-12-03
- Certified
- 2024-12-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.