Individual
KATELYN BRUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP- BC
Contact information
Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
Mailing address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209017354
IL
Other
Enumeration date
12/16/2018
Last updated
10/11/2022
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