Individual
KIRSTEN DIANE CLERKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 E GRANT ST, MACOMB, IL 61455-3352
(309) 833-1729
Mailing address
505 E GRANT ST, MACOMB, IL 61455-3352
(309) 833-1729
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209010601
IL
Other
Enumeration date
09/25/2013
Last updated
09/18/2014
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