KYLE D KIESEWETTER, Gerontology PEORIA, IL

Contact Information

KYLE D KIESEWETTER

221 NE GLEN OAK AVE
PEORIA, IL 61636-0001

Phone: 309-672-4859
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Gerontology	364SG0600X	89	Certified Clinical Nurse Specialist

Indicates primary specialty

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NPI Profile & details for KYLE D KIESEWETTER · (Male)

NPI #	`1598399693`
Status	Active
Credentials
Entity	Individual
Enumeration date	02/27/2020
Last updated	02/27/2020 - About 6 years ago
Sole proprietor ¹	No
Identifiers	IL License # 209.020932
Hospital affiliation(s)	METHODIST MEDICAL CENTER OF ILLINOIS - (Acute Care) 221 N E GLEN OAK AVE PEORIA, IL 61636

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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KYLE D KIESEWETTERGerontology

Contact Information

Specialty

Gerontology

NPI Profile & details for KYLE D KIESEWETTER · (Male)

Reviews for KYLE D KIESEWETTER

KYLE D KIESEWETTER
Gerontology