Individual
SARAH KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
221 NE GLEN OAK AVE, EMERGENCY DEPT, PEORIA, IL 61636-0001
(309) 999-1091
(309) 999-1094
Mailing address
PO BOX 309, MORTON, IL 61550-0309
(309) 370-1951
(609) 323-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.010398
IL
Other
Enumeration date
10/30/2013
Last updated
12/23/2013
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