Individual
KATHY A WILLENBORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PMHNP-BC
Contact information
Practice address
1000 N MAIN ST, ANNA, IL 62906-1652
(618) 202-6441
Mailing address
1000 N MAIN ST, ANNA, IL 62906-1652
(618) 202-6441
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209016361
IL
Other
Enumeration date
07/20/2011
Last updated
10/01/2022
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