Individual
KASSIDEE CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1228 E RUSHOLME ST, MOB 1 STE 2100, DAVENPORT, IA 52803-2453
(563) 421-8460
Mailing address
1406 35TH AVE, ROCK ISLAND, IL 61201-6102
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
H189738
IA
Other
Enumeration date
02/26/2026
Last updated
02/26/2026
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