Individual
KALI JO MOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1237 E MAIN ST, CARBONDALE, IL 62901-3148
(618) 457-2281
(618) 351-5625
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209021379
IL
363LF0000X
Family Nurse Practitioner
340962
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04546549
—
NY
Enumeration date
08/02/2016
Last updated
09/29/2025
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