IndividualActive
Agnes Fenner
NPI 1528518602 · Family Nurse Practitioner · Jacksonville, IL
Provider details
- NPI number
- 1528518602
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 209014954 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
15 Founders Ln
Jacksonville, IL 62650-3919
Phone: (217) 528-7541
Fax: (217) 527-3844
Approximate (ZIP-level) locationGet directions
Mailing address
1025 S 6th St
Springfield, IL 62703-2403
Registry dates
- Enumerated
- 2016-10-12
- Last updated
- 2020-06-18
- Certified
- 2020-06-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.