Individual
KIM A EARL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP, FNP
Contact information
Practice address
1124 S 6TH ST, SPRINGFIELD, IL 62703-2406
(217) 523-3143
(217) 523-1513
Mailing address
1124 S 6TH ST, SPRINGFIELD, IL 62703-2406
(217) 523-3143
(217) 523-1513
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209007155
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209007155
IL
Other
Enumeration date
08/27/2008
Last updated
05/18/2020
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