Individual
MS. KELLY JO BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1813 VALENCIA PL, PEKIN, IL 61554-6338
(309) 642-9211
Mailing address
1813 VALENCIA PL, PEKIN, IL 61554-6338
(309) 642-9211
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
285807
AZ
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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