Individual
BROOKE KENNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
326 FAIRWAY DR, BLOOMINGTON, IL 61701-3462
(309) 451-9595
(309) 451-9583
Mailing address
1505 BROAD CREEK RD, BLOOMINGTON, IL 61704-8525
(309) 532-1748
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209-014496
IL
363LF0000X
Family Nurse Practitioner
71008773A
IN
Other
Enumeration date
11/15/2016
Last updated
11/28/2023
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