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Search › Illinois › Student in an Organized Health Care Education/Training Program

Stacy Kannenberg

NPI 1790649986 · on the registry since 2025

Practice

Address
1516 E Kelly Ave
Peoria Heights, IL 61616
Phone
(309) 657-8779

Registry record

Primary taxonomy
Student in an Organized Health Care Education/Training Program
390200000X
Also registered as
Athletic Trainer
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2025-12-11

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois