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General NPI Number Information
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NPI Number | 1255812558
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Entity Type | Individual
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Provider Name | TRICIA LYNN KIERNY DNP, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 244 E PERSHING RD HEALTH CLINIC
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City | CHICAGO
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State | IL
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Zip | 60653-2222
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Country | US
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Telephone | 312-567-5686
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Fax |
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Provider Business Mailing Address
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Address Line | 355 E ERIE ST
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City | CHICAGO
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State | IL
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Zip | 60611-3167
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Country | US
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Telephone | 312-238-1000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.017961
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License Number State | IL
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