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NPI Code Detail

MEDICARE: MARY LUCINA KESSLER ACNS-BC, APRN

MEDICARE:   MARY LUCINA  KESSLER  ACNS-BC, APRN
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
1163WD0400XDiabetes Educator Registered Nurse79000009AIN
2163W00000XRegistered Nurse28135030AIN
3364S00000XClinical Nurse Specialist70000150AIN
4364SA2200XAdult Health Clinical Nurse Specialist70000150AIN

Other Identifiers

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

General Provider Information

NPI Number : 1619049301
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY LUCINA KESSLER ACNS-BC, APRN
Provider Business Mailing Address
First Line : PO BOX 775383
Second Line :
City : CHICAGO
State : IL
Zip : 60677-5383
Country : US
Telephone Number : 812-376-5315
Fax Number :
Provider Business Practice Location Address
First Line : 815 SCHNIER ST
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-2619
Country : US
Telephone Number : 812-376-5780
Fax Number : 812-376-5781
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 09/09/2024

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