MICHELE D MOLDREM


Address: 988 N Illinois Route 3, Waterloo, IL 62298
Phone: 6193934444

MICHELE D MOLDREM (NPI# 1598907545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598907545
Entity Type Individual
Full Name MICHELE D MOLDREM
Credential MHNP
Practice Address 988 N Illinois Route 3
Waterloo
IL 62298
Mailing Address 988 N Illinois Route 3
Waterloo
IL 62298-1059
Practice Telephone 6193934444
Mailing Telephone 6189394444
Enumeration Date 2009-04-06
Last Update Date 2018-09-28
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
209018106 IL Physician Assistants & Advanced Practice Nursing Providers
N 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
RN9265071 FL Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
5955 Zeamer Avenue, 3rd Mdg, Elmendorf Afb, AK 99506 9075802181

Office Location

Street Address 988 N ILLINOIS ROUTE 3
City WATERLOO
State IL
Zip Code 62298

Providers in the same location

NPI Name Taxonomy Address Enumeration
1427059476 Melissa I. Harris Counselor 988 N Illinois Route 3, Waterloo, IL 62298-1000 2005-08-02
1104425826 Lindsey Maag Rehabilitation Practitioner 988 N Illinois Route 3, Waterloo, IL 62298-1059 2020-10-23
1124638564 Anneleyce Dunlop Case Manager/Care Coordinator 988 N Illinois Route 3, Waterloo, IL 62298-1059 2020-07-31
1609404367 Emma Schmidt Case Manager/Care Coordinator 988 N Illinois Route 3, Waterloo, IL 62298-1059 2020-03-30
1245868900 Kizzy Partee Rehabilitation Practitioner 988 N Illinois Route 3, Waterloo, IL 62298-1059 2020-03-30
1245863612 Daniel Valleroy Case Manager/Care Coordinator 988 N Illinois Route 3, Waterloo, IL 62298-1059 2020-02-13
1982237350 Thea Palermo Case Manager/Care Coordinator 988 N Illinois Route 3, Waterloo, IL 62298-1059 2020-02-13
1255963997 Kristen Harris Rehabilitation Practitioner 988 N Illinois Route 3, Waterloo, IL 62298-1059 2020-02-11
1013549765 Amanda Sehr Rehabilitation Practitioner 988 N Illinois Route 3, Waterloo, IL 62298-1059 2020-02-11
1467084111 Trisha Talamantes Rehabilitation Practitioner 988 N Illinois Route 3, Waterloo, IL 62298-1059 2020-02-11
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1508471418 Waterloo Urgent Care Walk In Clinic Company Clinic/Center 901 Illinois Route 3, Waterloo, IL 62298 2020-09-09
1235624867 Las Davis Enterprises Hearing Instrument Specialist 911 State Rte 3, Waterloo, IL 62298 2018-06-26
1255727269 Anna Witges Counselor 988 Il-3, Waterloo, IL 62298 2015-04-07
1558766741 Sheri Buettner Counselor 988 Illinois Route 3, Waterloo, IL 62298 2014-10-30
1386050953 Jessica Liefer Counselor 988 N Illinois Rt 3, Waterloo, IL 62298 2014-07-03
1952729279 Orthodontic Associates of Columbia and Waterloo Dentist 224 Bradford Lane Suite B, Waterloo, IL 62298 2014-04-03
1588963961 Monroe County Surgical Center,llc Clinic/Center 501 Hamacher St, Waterloo, IL 62298 2011-03-24
1841523776 Waterloo Women's Health Nurse Practitioner 869 N. Illinois Rt 3, Waterloo, IL 62298 2009-09-10
1548444011 Marla Rae Smith Nurse Practitioner 869 North Illinois Rt 3, Waterloo, IL 62298 2007-12-20
1649464553 Clarkson Optometry Illinois PC Optometrist 204 Bradford Lane, Waterloo, IL 62298 2007-09-04
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356885024 Pro Care Mental Health Inc Nurse Practitioner 421 S 243rd St, Waterloo, NE 68069-4704 2016-12-14
1962025767 Abby Staudt Nurse Practitioner 1825 Logan Ave, Waterloo, IA 50703-1916 2020-05-27
1700366101 Kelly Scheffert Nurse Practitioner 1825 Logan Ave, Waterloo, IA 50703-1916 2018-08-16
1255823506 Nicole Delagardelle Nurse Practitioner 3251 W 9th St, Waterloo, IA 50702 2018-06-02
1962999672 Merve Akova Nurse Practitioner 146 W Dale St Ste 101, Waterloo, IA 50703-1901 2018-04-18
1932652757 Kelsie Swisher Nurse Practitioner 3251 W 9th St, Waterloo, IA 50702-5310 2016-07-28
1003216839 Evans Komen Nurse Practitioner 2750 Saint Francis Dr, Waterloo, IA 50702-5644 2014-08-29
1154637692 Joellen Cizek Kubik Nurse Practitioner 146 W Dale St, Suite 101, Waterloo, IA 50703-1901 2010-08-22
1013115757 Dianna Kay Magginetti Nurse Practitioner 905 Franklin St, Waterloo, IA 50703-4407 2007-07-03
1023178548 Dieter J Boxmann Nurse Practitioner 146 W Dale St, Suite 101, Waterloo, IA 50703-1901 2006-12-12
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Competitor

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City WATERLOO
Zip Code 62298

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Dataset Information

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.

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