Individual
MACIE KOHNERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
363 N WEST ST, OLNEY, IL 62450-1160
(618) 392-9400
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.027964
IL
Other
Enumeration date
08/04/2023
Last updated
12/31/2024
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