Individual provider · Type 1 NPI
Kelly M. Whitaker, NP
Adult Health Nurse Practitioner · Mascoutah, IL
NPI number
1386932028
Active
Practice location
124 W Main St
Mascoutah, IL 62258-2039
Fax (636) 333-4510
Mailing address
PO Box 303
Mascoutah, IL 62258-0303
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | 277.000945 (IL) |
Adult Health Nurse Practitioner: Definition to come...
2 other providers at this address
About NPI 1386932028
Kelly M. Whitaker, NP's National Provider Identifier is 1386932028, issued on Jul 15, 2011. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Mascoutah, IL. The record was last updated on Nov 19, 2024.