Individual
MICHELLE RENEE MIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
100 NE SAINT LUKES BLVD, LEES SUMMIT, MO 64086-6000
(816) 347-5000
Mailing address
4724 NE SARATOGA CT, LEES SUMMIT, MO 64064-2110
(816) 716-3938
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2021026754
MO
Other
Enumeration date
07/11/2021
Last updated
07/11/2021
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