Individual
KATHY MARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
1801 WINDSOR RD, CHAMPAIGN, IL 61822-6217
(217) 366-5434
(217) 366-6106
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1326
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
041362173
IL
363LG0600X
Gerontology Nurse Practitioner
083575
MO
Other
Enumeration date
03/08/2006
Last updated
09/02/2011
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