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NPI Code Detail

MEDICARE: KRISTIN MCDONALD APRN

MEDICARE:   KRISTIN  MCDONALD  APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner209.020587IL

General Provider Information

NPI Number : 1609401405
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN MCDONALD APRN
Provider Business Mailing Address
First Line : 109 CALIFORNIA ST
Second Line :
City : CARTERVILLE
State : IL
Zip : 62918-1923
Country : US
Telephone Number : 618-519-9200
Fax Number : 618-985-4635
Provider Business Practice Location Address
First Line : 3111 WILLIAMSON COUNTY PKWY
Second Line :
City : MARION
State : IL
Zip : 62959-5235
Country : US
Telephone Number : 618-519-9200
Fax Number : 618-985-9155
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2020
Last Update Date : 04/02/2026

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Directions to “ KRISTIN MCDONALD APRN” Practice Location

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