Individual
JERRY D KINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3620 BLOOMER DR, ALTON, IL 62002-5029
(618) 465-2016
Mailing address
3620 BLOOMER DR, ALTON, IL 62002-5029
(618) 465-2016
(618) 465-2016
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041258800
IL
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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