Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELSEY WICKENHAUSER, PA
ActiveKELSEY WICKENHAUSER, PA is a Physician Assistant healthcare provider located in GODFREY, Illinois. NPI 1972849321 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · GODFREY, IL
Registration Details
- NPI Number
- 1972849321
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 12, 2012 (13.667633865721 yrs)
- Last Updated
- May 13, 2014
- Licenses
-
2012037422 (MO)085 005 018 (IL)
Practice Information
- Address
-
1368 DADRIAN PROFESSIONAL PARKGODFREY, IL, 620351685Browse IL providers · Browse ZIP 62035
- Phone
- 3095309841
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in GODFREY, IL
| Name | Credential | NPI |
|---|---|---|
| MR. JAMES J HOPPER | PA-C | 1427016062 |
| MORGAN PETERS | PA-C | 1790295301 |
| LUCAS EDWARDS | — | 1790315018 |
| JESSICA N STRICKLIN | PA-C | 1124650353 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.