Individual
MS. NATASHA D BANCROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
4500 MEMORIAL DR, BELLEVILLE, IL 62226-5360
(618) 257-6220
Mailing address
18846 N HAILS LN, MOUNT VERNON, IL 62864-8312
(618) 237-2309
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209022987
IL
363LG0600X
Gerontology Nurse Practitioner
209022987
IL
Other
Enumeration date
04/14/2021
Last updated
09/19/2025
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