Individual
KRISTEN NICOLE MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
200 ADMIRAL TROST RD STE 1A, COLUMBIA, IL 62236-2164
(618) 281-7373
Mailing address
4017 STATE ROUTE 159 STE 101, SMITHTON, IL 62285-2510
(618) 257-2875
(618) 257-2895
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209010341
IL
363LP2300X
Primary Care Nurse Practitioner
209010341
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209010341
IL LIC
IL
Enumeration date
04/04/2013
Last updated
09/25/2025
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