Individual
KELSI D CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
525 E GRANT ST, MACOMB, IL 61455-3313
(309) 836-1542
Mailing address
826 S LAFAYETTE ST, MACOMB, IL 61455-2956
(217) 322-7373
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209016782
IL
Other
Enumeration date
07/20/2017
Last updated
10/20/2017
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