Provider Demographics
NPI:1699320234
Name:RINCKER, KATHRYN MICHELLE (APRN)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MICHELLE
Last Name:RINCKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:KATHRYN
Other - Middle Name:MICHELLE
Other - Last Name:RINCKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:503 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-2099
Mailing Address - Country:US
Mailing Address - Phone:217-342-2121
Mailing Address - Fax:
Practice Address - Street 1:503 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401
Practice Address - Country:US
Practice Address - Phone:217-342-2121
Practice Address - Fax:618-222-4703
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILF07190884363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care