Individual
KIMBERLY LISA JOAN PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
16342 N IL HWY 37, MOUNT VERNON, IL 62864
(618) 242-1510
(618) 242-0958
Mailing address
PO BOX 428, MOUNT VERNON, IL 62864-0054
(618) 242-1510
(618) 242-0958
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043056318
IL
171M00000X
Case Manager/Care Coordinator
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—
Other
Enumeration date
04/10/2009
Last updated
04/10/2009
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