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Mary Kennedy
Nurse Practitioner in Cullom, Illinois
NPI 1578656716

Mary Kennedy is a Nurse Practitioner based in Cullom, IL. Mary Kennedy practices in Cullom, IL. The NPI Number for Mary Kennedy is 1578656716 and holds a License No. 041127471/209001007 (Illinois).

The current practice location address for Mary Kennedy is 105 E Hack St, Cullom, IL and can be reached out via phone at 815-689-2126 and via fax at 815-689-2131.

Location: 105 E Hack St, Cullom, IL, 60929
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1578656716
Provider Name
Mary Kennedy
Credential
Provider Entity Type
Individual
Gender
Female
Address
105 E Hack St, Cullom, IL, 60929
Phone Number
815-689-2126
Fax Number
815-689-2131
Provider Enumeration Date
10/02/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
105 E Hack St
City
Cullom
State
Illinois
Zip
60929
Phone Number
815-689-2126
Fax Number
815-689-2131
person
Provider Business Mailing Address Details
Address
105 E Hack St
City
Cullom
State
Illinois
Zip
60929
Phone Number
815-689-2126
Fax Number
815-689-2131
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
041127471/209001007 (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.
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