Individual
SARA KRISTINE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
515 NE GLEN OAK AVE STE 202, PEORIA, IL 61603
(309) 624-4455
Mailing address
120 W JEFFERSON ST APT 35, MORTON, IL 61550-1849
(217) 972-9753
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209017253
IL
Other
Enumeration date
03/02/2018
Last updated
12/06/2022
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