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1104318666
KRISTA KAY PUCKETT
GLENVIEW, IL
NPI
1104318666
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209.017748)
Enumeration Date
2018-05-31
Last Update Date
2018-05-31
Business Address
KRISTA KAY PUCKETT APN
2701 PATRIOT BLVD
GLENVIEW, IL 60026-8039
Phone number: 847-475-2273
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Mailing Address
KRISTA KAY PUCKETT APN
424 S YALE AVE
VILLA PARK, IL 60181-2868
Phone number: 815-871-7897
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