Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | H163545 | IA |
NPI | 1477124329 |
---|---|
Provider Name | Kylie Taylor Abney |
First Address | East Moline, IL 61244-9735 |
Second Address | Peoria, IL 61636-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2021 |
Last Update Date | 01/07/2021 |