Individual
KIMANI FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 CENTENNIAL DR, EAST PEORIA, IL 61611-4916
(309) 324-0880
Mailing address
6224 N TALISMAN TER, PEORIA, IL 61615-2749
(309) 231-3184
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.029516
IL
Other
Enumeration date
08/08/2024
Last updated
08/08/2024
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