Kendra S Grounds, RN

Individual provider Active NPI Registered Nurse · Mount Carmel, IL

NPI 1447537675 · NPPES record last updated Nov 16, 2011

Key facts

NPI
1447537675
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
041298372 (IL)
Practice address
130 W 7TH St
Mount Carmel, IL 62863-1439
Phone
(618) 263-3873
Fax
(618) 262-4215
NPI assigned
Nov 16, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041298372ILMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041298372 IL Yes

Addresses

Primary practice location

130 W 7TH St
Mount Carmel, IL 62863-1439

Mailing address

14687 N 2000 Blvd
Allendale, IL 62410-2196
Phone (618) 299-2007

Other providers in Mount Carmel, IL

All providers in Mount Carmel, IL · Registered Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.