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Individual

JENNIFER LEE KOLETTIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
320 E ARMSTRONG AVE, PEORIA, IL 61603-3172
(309) 680-7600
(309) 495-8614
Mailing address
2214 N UNIVERSITY ST, PEORIA, IL 61604-3221
(309) 680-7669
(309) 681-8443

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
041-427636
IL

Other

Enumeration date
12/07/2018
Last updated
12/07/2018
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