Individual
EDWARD RANDY MIKEL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
15740 S OUTER 40 RD, CHESTERFIELD, MO 63017-2004
(636) 237-4200
Mailing address
15740 SOUTH OUTER 40 RD, CHESTERFIELD, MO 63017-2004
(636) 237-4200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017004747
MO
Other
Enumeration date
11/12/2018
Last updated
11/12/2018
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