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Corie Kathleen Smith

Nurse Practitioner in Shelbyville, IL. Individual provider (NPI-1).

NPI number1992523658
StatusActive
Last updated in NPPESNov 26, 2024

Details

NPI
1992523658
Entity type
Individual (NPI-1)
Name
Corie Kathleen Smith
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 1, 2024
Certification date
Nov 26, 2024
Last updated
Nov 26, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse Practitioner209030862ILYes
163W00000X Registered Nurse041480130IL

Practice location

200 S Cedar St
Shelbyville, IL 62565-1838

Phone 217-774-4400

Mailing address

200 S Cedar St
Shelbyville, IL 62565-1838

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