Individual
KELLY HORNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 19TH AVE STE 103, MOLINE, IL 61265-3700
(309) 779-7050
Mailing address
2810 28TH AVE, ROCK ISLAND, IL 61201-5476
(309) 373-4767
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209023292
IL
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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