Individual
KATHERINE STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1802 S. MATTIS AVENUE, ORTHOPEDICS, CHAMPAIGN, IL 61821
(217) 383-7676
(217) 383-4910
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209007439
IL
Other
Enumeration date
04/21/2009
Last updated
05/13/2014
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