Individual
CINDY KOHTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
702 W CHESTNUT ST, BLOOMINGTON, IL 61701-2814
(309) 557-1400
Mailing address
448 WYLIE DR, NORMAL, IL 61761-5405
(161) 851-2180
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209021824
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.021824
IL
Other
Enumeration date
01/19/2021
Last updated
07/11/2024
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