Individual
KELSEY FUQUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
727 E COURT ST, PARIS, IL 61944-2460
(217) 465-8411
Mailing address
721 E COURT ST, PARIS, IL 61944-2460
(217) 465-8411
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209024028
IL
363LF0000X
Family Nurse Practitioner
Primary
209024028
IL
Other
Enumeration date
09/27/2021
Last updated
09/29/2021
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