Doctor Name: | KATHERINE KINSELLA |
NPI Number: | 1306861463 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N, FNP |
License Number: | 309-000755 |
Business Practice Address: | 1051 W South St Kewanee, IL - 614438354 |
Business Phone Number: | 3098527700 |
Business Fax Number: | 3098527764 |
Mailing Address: | Po Box 747, KEWANEE |
State: | IL |
Postal Code: | 614430747 |
Phone Number: | 3098527700 |
Fax Number: | 3098527764 |
NPI Enumeration Date: | 07/12/2006 |
NPI Last Update Date: | 05/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 309-000755 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |