Provider Demographics
NPI:1861248791
Name:LEMKEMANN, KATHRYN SUZANNE (ARPN AGACNP-BC)
Entity type:Individual
Prefix:MISS
First Name:KATHRYN
Middle Name:SUZANNE
Last Name:LEMKEMANN
Suffix:
Gender:F
Credentials:ARPN AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 COUNTY ROAD 905 E
Mailing Address - Street 2:
Mailing Address - City:LOWPOINT
Mailing Address - State:IL
Mailing Address - Zip Code:61545-7527
Mailing Address - Country:US
Mailing Address - Phone:309-472-6551
Mailing Address - Fax:
Practice Address - Street 1:530 NE GLEN OAK AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61637-0001
Practice Address - Country:US
Practice Address - Phone:309-624-4649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041431428363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology