Individual
CARLY KRISTINE OUVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3315 N SEMINARY ST, GALESBURG, IL 61401-1251
(309) 344-1000
Mailing address
4582 335TH ST, FERTILE, IA 50434-8701
(641) 529-0691
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085.008903
IL
Other
Enumeration date
09/18/2020
Last updated
03/03/2022
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