Individual
MRS. KELLSEY R THOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
THREE SAINT ELIZABETH BLVD STE 2800, O FALLON, IL 62269-1282
(618) 233-6044
(833) 973-4218
Mailing address
THREE SAINT ELIZABETH BLVD STE 2800, O FALLON, IL 62269-1282
(618) 233-6044
(833) 973-4218
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
209.015758
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209.015758
IL
Other
Enumeration date
03/17/2017
Last updated
12/20/2021
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