DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: KACEY WOULFE CPNP-PC

MEDICARE: KACEY WOULFE CPNP-PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner209.034987IL

General Provider Information

NPI Number : 1417805409
Entity Type Code : Individual
Provider Name (Legal Business Name) : KACEY WOULFE CPNP-PC
Provider Business Mailing Address
First Line : 2166 MADISON AVE
Second Line :
City : GRANITE CITY
State : IL
Zip : 62040-4700
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2166 MADISON AVE
Second Line :
City : GRANITE CITY
State : IL
Zip : 62040-4700
Country : US
Telephone Number : 618-452-3301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2026
Last Update Date : 03/17/2026

Similar Medicare Providers

1457357147 — DR. BRIAN M FORBES D.C.
Practice Location Address:
4700 NAMEOKI RD
GRANITE CITY, IL
62040-2524
Practice Phone: 618-797-2225
Practice Fax: 618-797-2289
1851383301 — MICHAEL C ADAMS MD
Practice Location Address:
2166 MADISON AVE
GRANITE CITY, IL
62040-4700
Practice Phone: 618-452-3301
Practice Fax: 618-452-3312
1922068121 — DR. LEYLAND ARTHUR THOMAS MD
Practice Location Address:
2166 MADISON AVE
GRANITE CITY, IL
62040-4700
Practice Phone: 618-452-3301
Practice Fax: 618-452-3312
1063503704 — DR. KELLY M FARROLL MD
Practice Location Address:
2166 MADISON AVE
GRANITE CITY, IL
62040-4700
Practice Phone: 618-452-3301
Practice Fax: 618-452-3312
1386727584 — DR. MELVIN D MERRITT M.D.
Practice Location Address:
2166 MADISON AVE
GRANITE CITY, IL
62040-4700
Practice Phone: 618-451-4872
Practice Fax: 618-451-6203
1326104910 — MR. EDWARD CARL ANDERSON PA
Practice Location Address:
2166 MADISON AVE
GRANITE CITY, IL
62040-4700
Practice Phone: 618-452-3301
Practice Fax: 618-452-3312

Directions to “ KACEY WOULFE CPNP-PC” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.