Provider Demographics
NPI:1326501719
Name:MCGUIRE, KACEY MICHELLE (APRN)
Entity Type:Individual
Prefix:MS
First Name:KACEY
Middle Name:MICHELLE
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KACEY
Other - Middle Name:MICHELLE
Other - Last Name:HAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:721 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:IL
Mailing Address - Zip Code:61944-2420
Mailing Address - Country:US
Mailing Address - Phone:217-463-4340
Mailing Address - Fax:217-463-4345
Practice Address - Street 1:1 PHIPPS LN
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:IL
Practice Address - Zip Code:61944-2919
Practice Address - Country:US
Practice Address - Phone:217-463-4340
Practice Address - Fax:217-463-4345
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019101363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily