Individual
KELLY KARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1505 EASTLAND DR, BLOOMINGTON, IL 61701-3534
(309) 663-2100
(309) 663-8322
Mailing address
1505 EASTLAND DR, BLOOMINGTON, IL 61701-3534
(309) 663-2100
(309) 663-8322
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-370455
IL
363L00000X
Nurse Practitioner
Primary
209-013789
IL
Other
Enumeration date
12/01/2015
Last updated
03/05/2018
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