Individual
KATHERINE ELLINGSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP-BC
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
520 WITHERSPOON DR, SPRINGFIELD, IL 62704-1423
(651) 336-6010
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209.019388
IL
Other
Enumeration date
05/04/2019
Last updated
05/04/2019
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