Cody E Bilderback, FNP
Nurse Practitioner, Family in Alton, IL. Individual provider (NPI-1).
NPI number1467890657
StatusActive
Last updated in NPPESMay 9, 2023
Details
- NPI
- 1467890657
- Entity type
- Individual (NPI-1)
- Name
- Cody E Bilderback
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 10, 2013
- Certification date
- May 9, 2023
- Last updated
- May 9, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 209010451 | IL | Yes |
| 363LF0000X | Nurse Practitioner, Family | 2013012822 | MO |
Other names
- Cody E Basciano (Former Name)
Practice location
4 Memorial Dr Ste 230bAlton, IL 62002-6705
Phone 618-463-7874
Mailing address
4 Memorial Dr Ste 230bAlton, IL 62002-6705
Phone 618-463-7874
Other practice locations
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