Individual provider · Type 1 NPI

Kelsey Wickenhauser, PA

Physician Assistant · Godfrey, IL

NPI number 1972849321 Active

Practice location

1368 Dadrian Professional Park
Godfrey, IL 62035-1685

Mailing address

8416 Gannon Ave
St. Louis, MO 63132-4907

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X2012037422 (MO)
Physician Assistant Primary 363A00000X085 005 018 (IL)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1972849321

Kelsey Wickenhauser, PA's National Provider Identifier is 1972849321, issued on Dec 12, 2012. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Godfrey, IL. The record was last updated on May 13, 2014.