Individual provider · Type 1 NPI
Michelle Kethcart, APN
Family Nurse Practitioner · Maywood, IL
NPI number
1104392497
Active
Practice location
2160 S 1st Ave
Maywood, IL 60153-3328
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | 209.018213 (IL) |
| Family Nurse Practitioner Primary | 363LF0000X | 209018213 (IL) |
Family Nurse Practitioner: Definition to come...
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About NPI 1104392497
Michelle Kethcart, APN's National Provider Identifier is 1104392497, issued on Oct 15, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Maywood, IL. The record was last updated on Sep 15, 2023.