Ink & Ivy Psychiatry PLLC
Nurse Practitioner, Psych/Mental Health in Noble, IL. Organization (NPI-2).
NPI number1023948973
StatusActive
Last updated in NPPESOct 8, 2026
Details
- NPI
- 1023948973
- Entity type
- Organization (NPI-2)
- Legal business name
- Ink & Ivy Psychiatry PLLC
- Organization subpart
- No
- Enumeration date
- May 21, 2026
- Certification date
- Oct 8, 2026
- Last updated
- Oct 8, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
Practice location
113 E Walnut StNoble, IL 62868-1709
Phone 618-852-1395
Mailing address
113 E Walnut StNoble, IL 62868-1709
Phone 618-852-1395
Other practice locations
203 S Main St
Dieterich, IL 62424-1128
Dieterich, IL 62424-1128
Phone 618-852-1395
Authorized official
Jacklyn Kay Stanley
Owner
6188521395
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