Adcock, Kacie Rae

Adcock, Kacie Rae is an individual health care provider with primary practice located at 1 Childrens Pl Div Ped Emergency Med, Saint Louis MO 63110-1002. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Adcock, Kacie Rae can be contacted via phone (314) 454-2341.

Contact Information

Primary practice address
1 Childrens Pl Div Ped Emergency Med Saint Louis MO 63110-1002
Phone: (314) 454-2341
Fax: (314) 454-4345
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 2021026492 Missouri

Profile Details

NPI number 1134791270
LBN Legal business name Adcock, Kacie Rae
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2021
Last updated Apr 25th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134791270 NPPES
Missouri MEDICAID 420103558

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