Kendal Justice, PMHNP | |
6090 Strathmoor Dr Ste 1, Rockford, IL 61107-5200 | |
(815) 839-8180 | |
Not Available |
Full Name | Kendal Justice |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 6090 Strathmoor Dr Ste 1, Rockford, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427802966 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 209.029543 (Illinois) | Primary |
Entity Name | Montes Psychiatric Center Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629694278 PECOS PAC ID: 5991125585 Enrollment ID: O20201021000083 |
Mailing Address | Practice Location Address |
---|---|
Kendal Justice, PMHNP 6090 Strathmoor Dr Ste 1, Rockford, IL 61107-5200 Ph: () - | Kendal Justice, PMHNP 6090 Strathmoor Dr Ste 1, Rockford, IL 61107-5200 Ph: (815) 839-8180 |
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