Individual
KENDRA ANN PAULEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
375 N WALL ST STE P510, KANKAKEE, IL 60901-3492
(815) 935-0750
Mailing address
375 N WALL ST STE P510, KANKAKEE, IL 60901-3492
(815) 935-0750
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041454399
IL
363L00000X
Nurse Practitioner
Primary
209027052
IL
Other
Enumeration date
01/06/2023
Last updated
05/04/2023
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