Individual
CORIE KATHLEEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 S CEDAR ST, SHELBYVILLE, IL 62565-1838
(217) 774-4400
Mailing address
200 S CEDAR ST, SHELBYVILLE, IL 62565-1838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041480130
IL
363L00000X
Nurse Practitioner
Primary
209030862
IL
Other
Enumeration date
10/01/2024
Last updated
11/26/2024
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