Kelsey Marie Thacker

Nurse Practitioner · Mt Zion, IL

Individual Active NPI

NPI number 1245765296

Practice location

104 E Ashland Ave
Mt Zion, IL 62549-1271
Phone
(217) 864-2665
Fax
(217) 864-8042

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NPI record

NPI
1245765296
Entity type
Individual (Type 1)
Enumeration date
April 27, 2017
Last updated
April 27, 2017
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Nurse Practitioner Primary 363L00000X 209015926 IL

Mailing address

104 Ashland Avenue
Mt. Zion, IL 62549
Phone
(217) 864-2665
Fax
(217) 864-8042

About Kelsey Thacker

Kelsey Marie Thacker is a healthcare provider registered in the NPI registry with the primary taxonomy Nurse Practitioner (code 363L00000X). The practice location is 104 E Ashland Ave, Mt Zion, IL 62549-1271. The NPI number 1245765296 was assigned on April 27, 2017 and the record was last updated on April 27, 2017.

Kelsey Thacker lists a license in the registry: #209015926 (IL) for Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kelsey Marie Thacker?

The NPI number is 1245765296.

What is the phone number of Kelsey Thacker?

The phone number listed for the practice location is (217) 864-2665.

Where is Kelsey Thacker located?

104 E Ashland Ave, Mt Zion, IL 62549-1271.

What is the taxonomy code for Kelsey Thacker?

The primary taxonomy code is 363L00000X – Nurse Practitioner.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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