Kristin Thompson
Individual provider Active NPI Family Nurse Practitioner · Peoria, IL
NPI 1013602184 · NPPES record last updated Apr 5, 2023
Key facts
- NPI
- 1013602184
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209026932 (IL)
- Practice address
- 2001 W Willow Knolls Dr Ste 201
Peoria, IL 61614-1261 - Phone
- (309) 219-1140
- NPI assigned
- Apr 5, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209026932 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Balanced Life Medical Services LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209026932 | IL | Yes |
Addresses
Primary practice location
2001 W Willow Knolls Dr Ste 201
Peoria, IL 61614-1261
Mailing address
308 S Kansas Ave
Morton, IL 61550-2636
Phone (309) 258-8073
Other providers in Peoria, IL
- Glen D. Thompson
- Jennifer N Thompson
- Jeremiah James Thompson
- Kaylee Thompson
- Kristen Thompson
- Lauren Ellen Thompson
- Lori Thompson
- Maren Thompson
- Sherry Denise Thompson
- Stephen C Thompson
All providers in Peoria, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.