Individual
KILEE KENERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
420 N BURBANK AVE, ROCKFORD, IL 61101-5432
(779) 210-4824
Mailing address
420 N BURBANK AVE, ROCKFORD, IL 61101-5432
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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