Organization
INTEGRATED WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRYN EVANS FNP-C, FPA (FNP-C, FPA, OWNER)
(217) 491-0355
Entity
Organization
Contact information
Practice address
5016 N UNIVERSITY ST STE 104, PEORIA, IL 61614-4763
(217) 491-0355
Mailing address
5016 N UNIVERSITY ST STE 104, PEORIA, IL 61614-4763
(217) 491-0355
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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