Individual
KAYLEE NORDHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4016 9TH ST, ROCK ISLAND, IL 61201-6722
(309) 786-6474
Mailing address
1808 14TH ST, SILVIS, IL 61282-1985
(309) 781-0495
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043113969
IL
Other
Enumeration date
11/03/2015
Last updated
11/03/2015
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