Provider Demographics
NPI:1922571397
Name:CYRIER, KRISTIN MICHELLE (NP-C)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MICHELLE
Last Name:CYRIER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 N WALL ST STE P530
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-3486
Mailing Address - Country:US
Mailing Address - Phone:815-932-7200
Mailing Address - Fax:815-935-7874
Practice Address - Street 1:375 N WALL ST STE P530
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3486
Practice Address - Country:US
Practice Address - Phone:815-932-7200
Practice Address - Fax:815-935-7874
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041402137163W00000X
IL209018875363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse