Individual
KELLY BLANCHE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
250 WATER STONE CIR, JOLIET, IL 60431-8313
(815) 740-4104
Mailing address
1427 CHAMPLAIN ST, OTTAWA, IL 61350-2403
(219) 921-6844
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209027148
IL
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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