Individual
KIRSTEN MATTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
805 W FAYETTE AVE, EFFINGHAM, IL 62401-2415
(217) 342-9393
Mailing address
805 W FAYETTE AVE, EFFINGHAM, IL 62401-2415
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
041418450
IL
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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