| NPI | 1255099867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A BALDWIN Owner/Provider 815-520-1541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2021-12-04 |