MEDICARE: MS. KAYCE BOURGETTE HESTER FNP

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
1	363L00000X	Nurse Practitioner	2022015303	MO
2	363LF0000X	Family Nurse Practitioner	209026485	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114647039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAYCE BOURGETTE HESTER FNP

Provider Business Mailing Address
First Line	:	PO BOX 7412011
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674-2011
Country	:	US
Telephone Number	:	800-647-2098
Fax Number	:	618-622-9724

Provider Business Practice Location Address
First Line	:	6400 CLAYTON RD STE 302
Second Line	:
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1850
Country	:	US
Telephone Number	:	314-645-3370
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2022
Last Update Date	:	12/22/2025

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