Individual provider · Type 1 NPI

Kelsey Marie Thacker

Nurse Practitioner · Mount Zion, IL

NPI number 1245765296 Active

Practice location

104 E Ashland Ave
Mount Zion, IL 62549-1271

Fax (217) 864-8042

Mailing address

104 Ashland Avenue
Mount Zion, IL 62549

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X209015926 (IL)

Nurse Practitioner: (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 wit…

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About NPI 1245765296

Kelsey Marie Thacker's National Provider Identifier is 1245765296, issued on Apr 27, 2017. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Mount Zion, IL. The record was last updated on Apr 27, 2017.