Individual
KIMBERLY NIEUKIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
108 W MARKET ST, BLOOMINGTON, IL 61701-3918
(309) 827-5351
Mailing address
908 W BROADMOOR ST, PEORIA, IL 61614-3410
(309) 827-5351
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
041234797
IL
Other
Enumeration date
11/15/2013
Last updated
11/15/2013
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