Individual provider · Type 1 NPI
Mary K. Kiesewetter, PMHNP
Nurse Practitioner · Champaign, IL
Practice location
1802 S Mattis Ave
Champaign, IL 61821-5923
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 209020494 (IL) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 209.020494 (IL) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1114563640
Mary K. Kiesewetter, PMHNP's National Provider Identifier is 1114563640, issued on Nov 19, 2019. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Champaign, IL. The record was last updated on Nov 21, 2019.