Individual
KIMBERLY NORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1405 EASTLAND DR, BLOOMINGTON, IL 61701-3514
(309) 661-2400
Mailing address
1405 EASTLAND DR, BLOOMINGTON, IL 61701-3514
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
041278022
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
833120
MEDICAE GROUP #
—
Enumeration date
06/15/2006
Last updated
08/25/2010
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