Individual
MRS. KIMBERLEY DENISE CRISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
5031 N ILLINOIS ST, FAIRVIEW HEIGHTS, IL 62208-3453
(618) 212-6800
Mailing address
711 KASKASKIA ST, MENARD, IL 62259-1000
(618) 826-5071
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209006842
IL
Other
Enumeration date
07/06/2011
Last updated
01/18/2012
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