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Individual

DEIRDRE MAE MICKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
9 HDSN VLY PROF PLZ, NEWBURGH, NY 12550-3150
(845) 561-0990
(845) 562-1439
Mailing address
1 WEBSTER AVE STE 202, POUGHKEEPSIE, NY 12601-1362
(845) 483-5741
(845) 483-5713

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F420349
NY
363LF0000X
Family Nurse Practitioner
Primary
F420349
NY
363LW0102X
Women's Health Nurse Practitioner
F420349
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02462962
NY
Enumeration date
03/11/2008
Last updated
07/19/2021
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