Ms Kayce Justine Bourgette, FNP | |
1418 Cross St, Div Im Medical Oncology, Ste 180, Shiloh, IL 62269-2988 | |
(800) 647-2098 | |
(618) 622-9724 |
Full Name | Ms Kayce Justine Bourgette |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 1418 Cross St, Shiloh, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114647039 | NPI | - | NPPES |
420115728 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 209026485 (Illinois) | Primary |
Entity Name | Washington University Physicians In Illinois, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477076263 PECOS PAC ID: 4789945163 Enrollment ID: O20180227002018 |
Mailing Address | Practice Location Address |
---|---|
Ms Kayce Justine Bourgette, FNP 660 S Euclid Ave, Cb 8056, Saint Louis, MO 63110-1010 Ph: (314) 747-1171 | Ms Kayce Justine Bourgette, FNP 1418 Cross St, Div Im Medical Oncology, Ste 180, Shiloh, IL 62269-2988 Ph: (800) 647-2098 |
Danielle Lynn Frueh, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1170 Fortune Blvd, Shiloh, IL 62269 Phone: 618-997-5266 | |
Gaylin Manion, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1167 Fortune Blvd, Shiloh, IL 62269 Phone: 618-207-6900 Fax: 618-207-6901 | |
Christina Marie Weibley, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1170 Fortune Blvd, Shiloh, IL 62269 Phone: 618-997-5266 Fax: 833-431-2272 | |
Kristy Wienstroer, WHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1191 Fortune Blvd, Shiloh, IL 62269 Phone: 618-206-6101 | |
Katy Helene Wine, MSN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1414 Cross St Ste 240, Shiloh, IL 62269 Phone: 618-234-2390 Fax: 618-234-9936 | |
Ki Ristia J Allen-lampe, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1116 Hartman Ln, Shiloh, IL 62221 Phone: 618-641-9011 Fax: 618-641-9017 |