Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kyle D. Kiesewetter

Individual provider Gerontology Clinical Nurse Specialist · NPI 1598399693

Kyle D. Kiesewetter is a Gerontology Clinical Nurse Specialist in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2020.

Licensed in
IL
In the registry since
2020

Practice location Address checks out

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone: (309) 672-4859
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Clinical Nurse Specialist (primary) Taxonomy 364SG0600X · Licence 209.020932 (IL)

Record details

NPI number1598399693
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 27, 2020
Last updated in NPPESFebruary 27, 2020
Certification dateFebruary 27, 2020
Mailing address1210 N Old Trail Rd, East Peoria, IL 61611-1212

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