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KIMBERLY A KISH APN, CNP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1023360419

Individual Registrant:
 KIMBERLY A KISH APN, CNP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
407 S JACKSON ST STE A  CERRO GORDO, IL 61818-4360 US
Tel: 217-763-6010  Fax: 217-763-6012

Contact information for business:
1000 MEDICAL CENTER DR  MONTICELLO, IL 61856-2116 US
Tel: 217-762-6241  Fax: 217-762-1702

Registration Information:
NPI: 1023360419
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
IL209009873

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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