Individual
KATHLEEN PROBST
Active
Individual
KATHLEEN PROBST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
143113
MO
363LF0000X
Family Nurse Practitioner
Primary
209006709
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209006709
MEDICAL LICENSE NUMBER
IL
Enumeration date
08/14/2007
Last updated
12/23/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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