Provider Demographics
NPI:1861165367
Name:CATTERALL, ABIGAIL (MSN, APRN FNP-BC)
Entity type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:
Last Name:CATTERALL
Suffix:
Gender:F
Credentials:MSN, APRN FNP-BC
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN FNP-BC
Mailing Address - Street 1:6339 N BIG HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-2907
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6339 N BIG HOLLOW RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615-2907
Practice Address - Country:US
Practice Address - Phone:309-693-3315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.023570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily