Individual
KATELYN M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, CNP
Contact information
Practice address
200 E PENNSYLVANIA AVE, PEORIA, IL 61603-3089
(309) 624-4000
(309) 624-4010
Mailing address
200 E PENNSYLVANIA AVE, PEORIA, IL 61603-3089
(309) 624-4000
(309) 624-4010
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209018151
IL
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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