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General NPI Number Information
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NPI Number | 1386553626
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Entity Type | Individual
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Provider Name | THEA RANEE CYR RN
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Gender | Female
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 315 N KANSAS ST
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-1735
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Country | US
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Telephone | 618-656-5167
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Fax |
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Provider Business Mailing Address
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Address Line | 7004 AUGUSTA DR
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City | GLEN CARBON
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State | IL
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Zip | 62034-3030
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Country | US
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Telephone | 618-267-4201
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 041452404
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License Number State | IL
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