Individual
MRS. CARRIE JEAN KOGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
319 E MADISON ST, SPRINGFIELD, IL 62701-1035
(217) 788-3948
Mailing address
6630 COOLIDGE DR, CANTRALL, IL 62625-8885
(217) 971-4455
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.394318
IL
363LF0000X
Family Nurse Practitioner
Primary
209.024242
IL
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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