MRS. KILEY FAIRES (NPI# 1366806838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366806838 |
| Entity Type | Individual |
| Full Name | MRS. KILEY FAIRES |
| Credential | FNP-BC |
| Practice Address |
4600 Memorial Drive Ste 360 Belleville IL 62226 |
| Practice Telephone | 6182227280 |
| Practice Fax Number | 6182227281 |
| Mailing Telephone | 6182227280 |
| Mailing Fax Number | 6182227281 |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2018-11-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209014128 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4600 MEMORIAL DRIVE STE 360 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| 1295086973 | Paige Elizabeth Towers | Marriage & Family Therapist | 6 Emerald Terrace #4, Swansea, IL 62226 | 2012-09-21 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457958753 | Rita K Asiedu | Nurse Practitioner | 55 Washington Ave, Belleville, NJ 07109-2931 | 2020-10-08 |
| 1619590205 | Katelyn Rhea Coleman | Nurse Practitioner | 4600 Memorial Dr Ste 220, Belleville, IL 62226-5363 | 2020-05-18 |
| 1225663735 | Sarah Alleman | Nurse Practitioner | 3715 Rolling Meadows Dr, Belleville, IL 62221-0406 | 2020-03-04 |
| 1871130005 | Roselle Monica Pascual David | Nurse Practitioner | 511 Franklin Ave Apt B1, Belleville, NJ 07109-1568 | 2019-12-06 |
| 1003325952 | Kelsey Beasley | Nurse Practitioner | 3060 Harvest Meadow Dr, Belleville, IL 62221-7044 | 2017-09-22 |
| 1629527650 | Arika Forrest | Nurse Practitioner | 140 Iowa Ave, Belleville, IL 62220 | 2016-10-03 |
| 1518328624 | Crystal Stone | Nurse Practitioner | 100 N Jackson St Ste B, Belleville, IL 62220-1455 | 2016-03-16 |
| 1497181333 | Brittany Murry | Nurse Practitioner | 180 S 3rd St Ste 103, Belleville, IL 62220-1952 | 2013-09-24 |
| 1477893105 | Susan Lynne Bushinski | Nurse Practitioner | 44697 Greenbriar Dr, Belleville, MI 48111-5162 | 2013-02-16 |
| 1033257241 | Ariel G Almacen | Nurse Practitioner | 15 Lake St, Belleville, NJ 07109-1036 | 2007-02-01 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
Please comment or provide details below to improve the information on MRS. KILEY FAIRES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.