DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARY K KIESEWETTER, PMHNP

Active

MARY K KIESEWETTER, PMHNP is a Nurse Practitioner healthcare provider located in CHAMPAIGN, Illinois. NPI 1114563640 is currently active in the NPPES registry. Verify at CMS.

Nurse Practitioner · CHAMPAIGN, IL

Registration Details

NPI Number
1114563640
Provider Type
Individual
Gender
Female
NPI Issued
Nov 19, 2019 (6.691580943802 yrs)
Last Updated
Nov 21, 2019
Licenses
209020494 (IL)
209.020494 (IL)

Practice Information

Address
1802 S MATTIS AVE
CHAMPAIGN, IL, 618215923
Browse IL providers · Browse ZIP 61821
Phone
2173652855
Primary Specialty
Nurse Practitioner
363L00000X

Other Nurse Practitioner Providers in CHAMPAIGN, IL

Name Credential NPI
MARY STECH NP 1902849789
MA R DIFANIS NP 1851337109
MS. THERESA E. HARDY A.N.P.,IBCLC 1144237389
CHERYL MANGERS 1407862162
MS. KATHRYN J. GETTY 1932116159
VIRGINIA HINEGARDNER CNP 1215944459
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.