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NPI Code Detail

MEDICARE: KIRSTIN ANNE IGLEHART RN

MEDICARE: KIRSTIN ANNE IGLEHART RN
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
1163WP2201XAmbulatory Care Registered Nurse041433706IL

General Provider Information

NPI Number : 1932950003
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRSTIN ANNE IGLEHART RN
Provider Business Mailing Address
First Line : 415 N ELLIOTT ST
Second Line :
City : OLNEY
State : IL
Zip : 62450-3615
Country : US
Telephone Number : 618-843-4338
Fax Number : 618-392-7225
Provider Business Practice Location Address
First Line : 363 N WEST ST
Second Line :
City : OLNEY
State : IL
Zip : 62450-1160
Country : US
Telephone Number : 618-392-9400
Fax Number : 618-392-7225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2024
Last Update Date : 03/28/2024

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