Individual
KATHLEEN AVERILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2535 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3205
(612) 672-2350
Mailing address
1625 AVENUE OF THE CITIES, MOLINE, IL 61265-4856
(309) 797-5437
(309) 797-3140
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209-004900
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209-004900
CNP LICENSE
IL
01
—
6134
BOARD OF NURSING
MN
Enumeration date
10/25/2007
Last updated
01/04/2019
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