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Mary K Kiesewetter, PMHNP
Psychiatric/Mental Health Nurse Practitioner in Champaign, Illinois
NPI 1114563640

Mary K Kiesewetter is a Psychiatric/Mental Health Nurse Practitioner based in Champaign, IL and is specialized in Psychiatric/Mental Health. Mary K Kiesewetter practices in Champaign, IL and has the professional credentials of PMHNP. The NPI Number for Mary K Kiesewetter is 1114563640 and holds a License No. 209020494 (Illinois).

The current practice location address for Mary K Kiesewetter is 1802 S Mattis Ave, Champaign, IL and can be reached out via phone at 217-365-2855.

Location: 1802 S Mattis Ave, Champaign, IL, 61821-5923
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114563640
Provider Name
Mary K Kiesewetter
Credential
PMHNP
Provider Entity Type
Individual
Gender
Female
Address
1802 S Mattis Ave, Champaign, IL, 61821-5923
Phone Number
217-365-2855
Fax Number
Provider Enumeration Date
11/19/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1802 S Mattis Ave
City
Champaign
State
Illinois
Zip
61821-5923
Phone Number
217-365-2855
Fax Number
person
Provider Business Mailing Address Details
Address
1802 S Mattis Ave
City
Champaign
State
Illinois
Zip
61821-5923
Phone Number
217-365-2855
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
209.020494 (Illinois)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
209020494 (Illinois)
Definition
Definition to come...
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