Individual
MICHELLE R MICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5772
Mailing address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5772
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2016035597
MO
363LA2200X
Adult Health Nurse Practitioner
2016035597
MO
Other
Enumeration date
11/28/2016
Last updated
10/12/2023
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