Individual
KATELYN M. FESSENDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4038
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041393488
IL
363LF0000X
Family Nurse Practitioner
Primary
209015707
IL
Other
Enumeration date
02/28/2017
Last updated
04/21/2017
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