KELLY DESMARAIS APRN
NPI 1417830803
Nurse Practitioner in Peoria, IL

Q: What is Kelly Desmarais's NPI number?

The NPI number for Kelly Desmarais is 1417830803. It was assigned to this individual provider in the NPPES registry on July 31, 2025.

Q: What is Kelly Desmarais's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Desmarais was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 31, 2025

719 N WILLIAM KUMPF BLVD STE 100, PEORIA, IL 61605(309) 624-9934 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kelly Desmarais Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY DESMARAIS APRN (NPI 1417830803) is an individual nurse practitioner in Peoria, Illinois, licensed in Illinois (209.032862) and active in the NPI registry since July 2025.

NPPES Registry Identity

NPI1417830803

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameKELLY DESMARAISCredential: APRN

Location Address719 N WILLIAM KUMPF BLVD STE 100Peoria, IL 61605-2531

Mailing Address15776 Herberger RdMackinaw, IL 61755-9221

Phone(309) 624-9934

Sole ProprietorYes

Enumeration DateJuly 31, 2025

NPPES CertifiedJuly 31, 2025

✔ NPI 1417830803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IL · 209.032862

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

719 N WILLIAM KUMPF BLVD STE 100, Peoria, IL 61605

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Desmarais's NPI number?

The NPI number for Kelly Desmarais is 1417830803. It was assigned to this individual provider in the NPPES registry on July 31, 2025.

Where is Kelly Desmarais located?

Kelly Desmarais practices at 719 N William Kumpf Blvd Ste 100, Peoria, IL 61605. The listed phone number is (309) 624-9934.

What is Kelly Desmarais's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Kelly Desmarais was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.