Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. KIM KEITH WIESE, PA-C
ActiveMR. KIM KEITH WIESE, PA-C is a Physician Assistant healthcare provider located in PEORIA, Illinois. NPI 1801866744 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · PEORIA, IL
Registration Details
- NPI Number
- 1801866744
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 24, 2006 (20.368890261075 yrs)
- Last Updated
- May 19, 2020
- License
-
085.006503 (IL)
Practice Information
- Address
-
1524 W GLEN AVEPEORIA, IL, 616144692Browse IL providers · Browse ZIP 61614
- Phone
- 3095120902
- Fax
- 0940303973
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in PEORIA, IL
| Name | Credential | NPI |
|---|---|---|
| MR. KEVIN SNOW | PA-C | 1275533317 |
| SHARON AYCOCK | PA-C | 1104813997 |
| LISA K NIELSEN | PA-C | 1982688669 |
| CONSTANCE M FREIDINGER | PA-C | 1487639118 |
| MR. RANDALL LANE WILCOXEN | PAC | 1851363022 |
| MR. RICHARD TODD KERR | PA-C, ATC | 1881662385 |
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.