Individual
KELLY L PERISIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2426 W CORNERSTONE CT STE 100, PEORIA, IL 61614-2400
(309) 966-3137
Mailing address
2608 W SESAME ST, DUNLAP, IL 61525-7527
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209017367
IL
Other
Enumeration date
04/13/2018
Last updated
08/09/2021
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