Individual
CANDACE CRYSTAL KUDLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1506 W REYNOLDS ST, PONTIAC, IL 61764-9674
(815) 844-6123
(815) 844-3897
Mailing address
500 S REDBUD LN, FLANAGAN, IL 61740-9111
(815) 257-1237
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
209023553
IL
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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