Individual
ROXANNE MIKESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3800 S NATIONAL AVE STE 400, SPRINGFIELD, MO 65807-5272
(417) 875-3210
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
083182
MO
363LF0000X
Family Nurse Practitioner
Primary
83182
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
083182
STATE LICENSE
MO
05
—
1861591257
—
MO
Enumeration date
09/22/2006
Last updated
09/10/2013
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