Individual
KEYOMA DONTA JAMERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1701 E COURT, KANKAKEE, IL 60901-3661
(815) 995-9394
Mailing address
1701 E COURT, KANKAKEE, IL 60901-4541
(815) 671-2992
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209011266
IL
Other
Enumeration date
04/24/2014
Last updated
02/24/2016
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