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Individual
KELLY NICHOLE ECKHART
Active
Individual
KELLY NICHOLE ECKHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.413014
IL
163W00000X
Registered Nurse
Primary
197954-30
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.034966
IL
Other
Enumeration date
07/19/2016
Last updated
03/30/2026
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