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).
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 |
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 |
Address | Telephone Number | Fax Number |
---|---|---|
5955 Zeamer Avenue, 3rd Mdg, Elmendorf Afb, AK 99506 | 9075802181 |
Street Address |
988 N ILLINOIS ROUTE 3 |
City | WATERLOO |
State | IL |
Zip Code | 62298 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 62298 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
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 |
Find all providers in WATERLOO |
Please comment or provide details below to improve the information on MICHELE D MOLDREM.
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.