Provider Demographics
NPI:1972903862
Name:KORTE, MAEGAN E (FNP-C)
Entity type:Individual
Prefix:
First Name:MAEGAN
Middle Name:E
Last Name:KORTE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 W LINCOLN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-1902
Mailing Address - Country:US
Mailing Address - Phone:618-234-2566
Mailing Address - Fax:618-234-5650
Practice Address - Street 1:311 W LINCOLN ST STE 200
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-1902
Practice Address - Country:US
Practice Address - Phone:618-234-2566
Practice Address - Fax:618-234-5650
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209011852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily