Individual
KAYLA R DETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, FNP-BC
Contact information
Practice address
1303 W EVERGREEN AVE STE 200, EFFINGHAM, IL 62401-1638
(217) 342-3400
(217) 342-6417
Mailing address
1005 HEALTH CENTER DR STE 201, MATTOON, IL 61938-4653
(217) 868-2812
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209016977
IL
363LF0000X
Family Nurse Practitioner
Primary
209016977
IL
Other
Enumeration date
01/12/2018
Last updated
01/24/2023
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