Individual
KIMBERLY SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
121 S MAIN ST, CARROLLTON, IL 62016-1340
(217) 939-0236
Mailing address
202 BRUCE DR, WHITE HALL, IL 62092-1178
(217) 939-1307
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043078572
IL
Other
Enumeration date
05/02/2025
Last updated
05/02/2025
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