1942761069 NPI number — MISS KELCY FRANCIS SAYLER FNP-C

Table of content: MISS KELCY FRANCIS SAYLER FNP-C (NPI 1942761069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942761069 NPI number — MISS KELCY FRANCIS SAYLER FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAYLER
Provider First Name:
KELCY
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAYLER
Provider Other First Name:
KELCY
Provider Other Middle Name:
FRANCIS
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP-C
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1942761069
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2215 BROADWAY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAPE GIRARDEAU
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63701-4403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-271-5317
Provider Business Mailing Address Fax Number:
573-335-6724

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 N KINGSHIGHWAY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAPE GIRARDEAU
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63701-2127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-335-1999
Provider Business Practice Location Address Fax Number:
573-335-1997
Provider Enumeration Date:
03/29/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  2019009783 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 420072577 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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