Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kacey Woulfe, CPNP-PC

Individual provider Pediatric Nurse Practitioner · NPI 1417805409

Kacey Woulfe, CPNP-PC is a Nurse Practitioner in Granite City, Illinois. Qualified in 2025, 1 year ago. Licensed in Illinois.

Years since qualifying
1
Licensed in
IL
In the registry since
2026

Practice location Address checks out

2166 Madison Ave
Granite City, IL 62040-4700
Phone: (618) 452-3301
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence 209.034987 (IL)

Record details

NPI number1417805409
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPNP-PC
Sole proprietorNo
NPI enumeratedMarch 17, 2026
Last updated in NPPESMarch 17, 2026
Certification dateMarch 17, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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