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Contact Information

JENNIFER E KISTNER, FNP
203 S MAIN ST
DIETERICH, IL62424
 Phone: 217-925-5730
 Fax: 217-925-5736
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for JENNIFER E KISTNER · (Female)

NPI # 1972892313
Status Active
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 04/06/2011
Last updated 06/30/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 209008758
  • IL Other 209008758 NURSE PRACTITIONER LICENSE
  • IL Other 041359392 RN LICENSE
Hospital affiliation(s)
  • SARAH BUSH LINCOLN HEALTH CENTER - (Acute Care)
    1000 HEALTH CENTER DRIVE P O BOX 372
    MATTOON, IL 61938
  • ST ANTHONYS MEMORIAL HOSPITAL - (Acute Care)
    503 N MAPLE STREET
    EFFINGHAM, IL 62401
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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