MICHELLE MICK (NPI# 1033652862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033652862 |
| Entity Type | Individual |
| Full Name | MICHELLE MICK |
| Credential | ANP-C |
| Practice Address |
12 Jefferson Sq De Soto MO 63020-1031 |
| Practice Telephone | 6365866685 |
| Mailing Telephone | 6365866685 |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2016-11-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
2016035597 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588017776 | Michelle Mick | Registered Nurse | 301 Meade St, Wilkinsburg, PA 15221-2131 | 2016-07-22 |
| Street Address |
12 JEFFERSON SQ |
| City | DE SOTO |
| State | MO |
| Zip Code | 63020-1031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548266737 | Steven Crawford | Family Medicine | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2005-06-22 |
| 1720595200 | Danielle Marie Howerton | Nurse Practitioner | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2018-01-05 |
| 1508264946 | Becky Sue Hammon | Nurse Practitioner | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2014-12-17 |
| 1790037885 | Hattie Debord | Nurse Practitioner | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2012-10-12 |
| 1245455880 | Rowden Family Medicine, PC | Family Medicine | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2007-04-17 |
| 1689608291 | Jim Clark Sanders | Family Medicine | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2006-07-10 |
| 1255324828 | Phillip R Cummings | Nurse Practitioner | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2005-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700435385 | Patsy Maness | Technician | 5100 Knorpp Road, De Soto, MO 63020 | 2019-09-06 |
| 1013268911 | Jane Susann Brenneke | Counselor | 116 B 2nd Street, Desoto, MO 63020 | 2012-10-02 |
| 1477634277 | Wal-mart Stores East, Lp | Technician/Technologist | 12862 State Road 21, De Soto, MO 63020 | 2006-10-18 |
| 1235109877 | John W Dickinson | Dentist | 704 N Main Street, Desoto, MO 63020 | 2006-01-25 |
| 1700883253 | Valle Ambulance District | Ambulance | 12363 State Route 21, De Soto, MO 63020 | 2005-06-30 |
| 1568893105 | Terence A. Friskel | Dentist | 110 North Main, Desoto, MO 63020 | 2013-12-09 |
| 1457541427 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 12977 State Route 21, De Soto, MO 63020-1000 | 2007-07-26 |
| 1982880084 | Thomas L. Monje, O.d. | Optometrist | 26 Jefferson Sq, De Soto, MO 63020-1031 | 2008-01-18 |
| 1700182318 | Rowden Family Medicine PC | Clinic/Center | 400b W Lueking Dr, De Soto, MO 63020-1042 | 2011-01-28 |
| 1982052759 | Southern Home Care Services, Inc. | In Home Supportive Care | 1809a Rock Rd, De Soto, MO 63020-1047 | 2016-06-02 |
| Find all providers in zip 63020 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962678730 | Kathleen M O'rourke | Nurse Practitioner | 127 W Pratt St, De Soto, MO 63020-2107 | 2008-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619285 | Jennifer Lee Speiser | Nurse Practitioner | 12545 Olive Blvd, Saint Louis, MO 63141-6311 | 2020-11-04 |
| 1215537220 | John Franklin Niswonger | Nurse Practitioner | 861 Canyon Trl, Jackson, MO 63755-4001 | 2020-10-28 |
| 1972119014 | Michael Christopher Hassert | Nurse Practitioner | 2290 Graystone Dr, Saint Charles, MO 63303-5159 | 2020-09-22 |
| 1265045264 | Andrea Jane Montgomery | Nurse Practitioner | 444 Honeysuckle Ln, Saint Louis, MO 63119-4521 | 2020-08-28 |
| 1710596424 | Clay Thornburg | Nurse Practitioner | 602 S Home St, Palmyra, MO 63461-1747 | 2020-07-28 |
| 1396362224 | Erin M Kehoe | Nurse Practitioner | 12973 Olive Blvd, Saint Louis, MO 63141-6149 | 2020-06-26 |
| 1508482506 | Matthew Dale Tieskoetter | Nurse Practitioner | 333 S Kirkwood Rd Ste 203, Saint Louis, MO 63122-6161 | 2020-06-25 |
| 1497391924 | Stephnie Michelle Wriedt | Nurse Practitioner | 1605 E Broadway Ste 250, Columbia, MO 65201-8031 | 2019-11-19 |
| 1861033615 | Benedicta Esi | Nurse Practitioner | 6024 Pennsylvania Ave, Saint Louis, MO 63111-2555 | 2019-10-02 |
| 1245896893 | Katina D Smith | Nurse Practitioner | 8820 Mcnulty Dr, Saint Louis, MO 63114-4146 | 2019-05-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.