SUSAN E MITCHELL-DERENSKI (NPI# 1629329578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629329578 |
Entity Type | Individual |
Full Name | SUSAN E MITCHELL-DERENSKI |
Other Name | SUSAN E MITCHELL |
Credential | WHNP |
Practice Address |
20 Progress Point Pkwy Ste 100 O Fallon MO 63368-2206 |
Mailing Address |
670 Mason Ridge Center Dr Ste 300 Saint Louis MO 63141-8573 |
Practice Telephone | 6363443105 |
Practice Fax Number | 6363443104 |
Mailing Telephone | 6363443105 |
Mailing Fax Number | 6363443104 |
Enumeration Date | 2012-10-01 |
Last Update Date | 2015-11-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163W00000X | Registered Nurse | 2006026079 | MO | Nursing Service Providers |
Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
2012036251 | MO | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
20 PROGRESS POINT PKWY STE 100 |
City | O FALLON |
State | MO |
Zip Code | 63368-2206 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649273160 | Stephanie L Sandberg | Internal Medicine | 20 Progress Point Pkwy, Suite 206, O Fallon, MO 63368-2206 | 2005-05-30 |
1821500778 | Washington University | Durable Medical Equipment & Medical Supplies | 20 Progress Point Pkwy, O Fallon, MO 63368-2206 | 2017-11-01 |
1477910461 | Angela C Clercx | Registered Nurse | 20 Progress Point Pkwy, Ste 108, O Fallon, MO 63368-2206 | 2016-01-21 |
1366830572 | Wuca-o'fallon Pediatrics, LLC | Pediatrics | 20 Progress Point Pkwy, Suite 220, O Fallon, MO 63368-2206 | 2014-12-23 |
1841612850 | Emily Suzanne Hammer | Nurse Practitioner | 20 Progress Point Pkwy, Suite 200, O Fallon, MO 63368-2206 | 2014-01-09 |
1417211756 | Nikol Lei Smart | Obstetrics & Gynecology | 20 Progress Point Pkwy, Ste 206, O Fallon, MO 63368-2206 | 2012-07-02 |
1942513205 | Catherine L Crass | Nurse Practitioner | 20 Progress Point Pkwy, Suite 200, O Fallon, MO 63368-2206 | 2010-07-15 |
1578875647 | Cory Scott Miller | Obstetrics & Gynecology | 20 Progress Point Pkwy, Ste 206, O Fallon, MO 63368-2206 | 2010-07-06 |
1619100989 | Jamie Lee Tueth | Internal Medicine | 20 Progress Point Pkwy, Ste 108, O Fallon, MO 63368-2206 | 2009-09-02 |
1477717080 | Milton Oludhe Ochieng' | Internal Medicine | 20 Progress Point Pkwy, Ste 108, O Fallon, MO 63368-2206 | 2008-07-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134720329 | Come As You Are Counseling LLC | Counselor | 1001 Boardwalk Springs Place, Suite 111, O Fallon, MO 63368 | 2020-11-04 |
1770124802 | Lisa N. Greer | Technician | 6911 Brassel Dr., Ofallon, MO 63368 | 2019-09-30 |
1770145716 | Halie Faye Gulley | Dentist | 3009 Hwy K, O'fallon, MO 63368 | 2019-06-29 |
1972079556 | Erin Corsi Fraundorf | Dentist | 3009 State Hwy K, O'fallon, MO 63368 | 2018-10-22 |
1427579960 | Air Evac Ems, Inc. | Ambulance | 1001 Boardwalk Springs Pl Ste 250, O Fallon, MO 63368 | 2017-07-06 |
1528507472 | Washeck Manual Therapy LLC | Clinic/Center | 3074 Winghaven Blvd, O'fallon, MO 63368 | 2017-02-13 |
1639618457 | Brittany Hogan | Physical Therapist | 7412 South Outer 364, Suite B, Dardenne Prairie, MO 63368 | 2017-02-13 |
1124561469 | Cardinal Home Care LLC | Home Health | 18 Convent Garden Ct, O'fallon, MO 63368 | 2016-11-18 |
1336509272 | Sarah Marie Mudd | Counselor | 1654 Bryan Road, O'fallon, MO 63368 | 2016-03-04 |
1588023956 | Price-bourisaw Family Chiropractic | Chiropractor | 2917 State Highway K, O Fallon, MO 63368 | 2016-02-15 |
Find all providers in zip 63368 |
Taxonomy Code | 363LW0102X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Women's Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841612850 | Emily Suzanne Hammer | Nurse Practitioner | 20 Progress Point Pkwy, Suite 200, O Fallon, MO 63368-2206 | 2014-01-09 |
1942513205 | Catherine L Crass | Nurse Practitioner | 20 Progress Point Pkwy, Suite 200, O Fallon, MO 63368-2206 | 2010-07-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356956304 | Andrea Marie Sleeth | Nurse Practitioner | 3329 W Sexton St, Springfield, MO 65810-1080 | 2020-09-15 |
1972112720 | Amy Elizabeth Richardson | Nurse Practitioner | 306 E Summit St, Doniphan, MO 63935-1332 | 2020-07-28 |
1417578873 | Saskia Naomi Chaskelson | Nurse Practitioner | 1309 Louisville Ave, Saint Louis, MO 63139-3421 | 2020-04-27 |
1811531395 | Melanie Melissa Miranda | Nurse Practitioner | 23 Clayton Ter, Frontenac, MO 63131-2920 | 2019-10-29 |
1902450695 | Erica Walter | Nurse Practitioner | 4590 Childrens Pl Fl 4, Saint Louis, MO 63110-1020 | 2019-07-31 |
1285288274 | Megan Cecile Johnson | Nurse Practitioner | 7924 Ne 53rd St, Kansas City, MO 64119-4149 | 2019-07-28 |
1255839916 | Valerie Latrice Johnson | Nurse Practitioner | 2796 N Lindbergh Blvd, Florissant, MO 63033-1402 | 2018-01-29 |
1801305677 | Courtney E Turnbough | Nurse Practitioner | 621 S New Ballas Rd Ste 2002b, Saint Louis, MO 63141-8265 | 2017-09-25 |
1710357280 | Terri Lablance | Nurse Practitioner | 3905 Bernard Powell Dr, Kansas City, MO 64127-3427 | 2015-09-28 |
1932443058 | Catherine Griffin | Nurse Practitioner | 33 Ayrshire Rd., St. Charles, MO 63303-3129 | 2012-11-15 |
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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.