Individual provider · Type 1 NPI
Kendall Christidis
Pediatric Nurse Practitioner · Beloit, WI
NPI number
1124748405
Active
Practice location
74 Eclipse Ctr
Beloit, WI 53511-3550
Fax (608) 361-0312
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 209025846 (IL) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | 14537-33 (WI) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1124748405
Kendall Christidis's National Provider Identifier is 1124748405, issued on Aug 29, 2022. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Beloit, WI. The record was last updated on Jan 30, 2024.