Individual provider · Type 1 NPI
Kelly Desmarais, APRN
Nurse Practitioner · Peoria, IL
Practice location
719 N William Kumpf Blvd Ste 100
Peoria, IL 61605-2531
Mailing address
15776 Herberger Rd
Mackinaw, IL 61755-9221
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 209.032862 (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 1417830803
Kelly Desmarais, APRN's National Provider Identifier is 1417830803, issued on Jul 31, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Peoria, IL. The record was last updated on Jul 31, 2025.