Provider Demographics
NPI:1861867863
Name:ADVANCED PRACTICE NURSING SERVICES INC
Entity type:Organization
Organization Name:ADVANCED PRACTICE NURSING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:618-792-3586
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:MASCOUTAH
Mailing Address - State:IL
Mailing Address - Zip Code:62258-0303
Mailing Address - Country:US
Mailing Address - Phone:618-792-3586
Mailing Address - Fax:636-333-4510
Practice Address - Street 1:746 URBANNA DR
Practice Address - Street 2:
Practice Address - City:FREEBURG
Practice Address - State:IL
Practice Address - Zip Code:62243-1904
Practice Address - Country:US
Practice Address - Phone:618-792-3586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2023-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty