Provider Demographics
NPI:1043631484
Name:ALLENDER, KALLIE ELIZABETH (FNP-C,MSN,RN)
Entity type:Individual
Prefix:
First Name:KALLIE
Middle Name:ELIZABETH
Last Name:ALLENDER
Suffix:
Gender:F
Credentials:FNP-C,MSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:IL
Mailing Address - Zip Code:62863-1607
Mailing Address - Country:US
Mailing Address - Phone:618-262-6335
Mailing Address - Fax:618-551-8460
Practice Address - Street 1:126 W 2ND ST
Practice Address - Street 2:
Practice Address - City:MOUNT CARMEL
Practice Address - State:IL
Practice Address - Zip Code:62863-1607
Practice Address - Country:US
Practice Address - Phone:618-263-8427
Practice Address - Fax:618-551-8460
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28190144A163W00000X
IN71004763A363L00000X
IL209011152363L00000X
IL20911152363LF0000X
IL277001437363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily