Individual
KATHERINE KINSELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N, FNP
Contact information
Practice address
1051 W SOUTH ST, KEWANEE, IL 61443-8354
(309) 852-7700
(309) 852-7764
Mailing address
PO BOX 747, KEWANEE, IL 61443-0747
(309) 852-7700
(309) 852-7764
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
309-000755
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3715468
BLUE CROSS BLUE SHIELD
IL
01
—
371548
BC/BS
IL
Enumeration date
07/12/2006
Last updated
05/30/2008
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