Individual
KEVIN ROSBOROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
1096 1350TH ST, LINCOLN, IL 62656-5094
(217) 735-5581
Mailing address
420 N BELMONT ST, MOUNT PULASKI, IL 62548-1002
(217) 855-1184
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.017402
IL
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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