IndividualActive
Courtney O'Keefe, CPNP-PC
NPI 1194432005 · Pediatric Nurse Practitioner · Waterloo, IL
Provider details
- NPI number
- 1194432005
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CPNP-PC
- Sex
- Female
- Sole proprietor
- No
- License
- 209026307 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
224 Bradford Ln
Waterloo, IL 62298-3369
Phone: (618) 939-0112
Fax: (618) 939-0119
Approximate (ZIP-level) locationGet directions
Mailing address
224 Bradford Ln
Waterloo, IL 62298-3369
Registry dates
- Enumerated
- 2022-10-31
- Last updated
- 2026-06-03
- Certified
- 2026-06-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.