Individual
KATELYN RUPERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8600 STATE ROUTE 91 STE 250, PEORIA, IL 61615-7831
(309) 692-5393
(309) 692-2538
Mailing address
8600 STATE ROUTE 91 STE 250, PEORIA, IL 61615-7831
(309) 692-5393
(309) 692-2538
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209-017291
IL
Other
Enumeration date
03/02/2018
Last updated
03/02/2018
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