Kaitlyn Tucker, CNP
Nurse Practitioner, Family in Springfield, IL. Individual provider (NPI-1).
NPI number1164068805
StatusActive
Last updated in NPPESOct 6, 2023
Details
- NPI
- 1164068805
- Entity type
- Individual (NPI-1)
- Name
- Kaitlyn Tucker
- Credential
- CNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 18, 2019
- Certification date
- Oct 6, 2023
- Last updated
- Oct 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 209.020167 | IL | Yes |
Other names
- Kaitlyn Stauffer (Former Name)
Practice location
800 N 1st StSpringfield, IL 62702-3778
Phone 217-528-7541
Mailing address
Po Box 19248Springfield, IL 62794-9248
Phone 217-528-7541
Other practice locations
26 Knollwood Dr
Sherman, IL 62684-9559
Sherman, IL 62684-9559
Phone 217-828-0764
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