Wiese, Kim Keith
Wiese, Kim Keith is an individual health care provider with primary practice located at 1524 W Glen Ave , Peoria IL 61614-4692. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Wiese, Kim Keith can be contacted via phone (309) 512-0902.Contact Information
Primary practice address
1524 W Glen Ave
Peoria IL 61614-4692
Phone: (309) 512-0902
Fax: (094) 030-3973
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 085.006503 | Illinois |
Profile Details
NPI number | 1801866744 |
---|---|
LBN Legal business name | Wiese, Kim Keith |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 24th, 2006 |
Last updated | May 19th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Popular Providers
-
Miller, Richard Andrew
7301 N Knoxville Ave , Peoria IL 61614-2017 -
Walker, Holly R
420 Ne Glen Oak Ave Ste 401 , Peoria IL 61603-3168 -
Wilcoxen, Randall Lane
5114 N Glen Park Place Rd , Peoria IL 61614-4686 -
Henderson, Heidi
221 Ne Glen Oak Ave , Peoria IL 61636-0001 -
Nielsen, Lisa K
7309 N Knoxville Ave , Peoria IL 61614-2085 -
Svymbersky, Alesia
6000 N Allen Rd , Peoria IL 61614-3294 -
Tanner, Dawn Clarisse
221 Ne Glen Oak Ave , Peoria IL 61603-4307 -
Watson, Joy M
4909 N Glen Park Place Rd , Peoria IL 61614-4676