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Michelle R Mick

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

3015 N Ballas Rd, Saint Louis, MO 63131-2329

PECOS Enrollment

This provider is enrolled in PECOS as MICHELLE MICK.

Based on the most recent information from CMS, provider Michelle R Mick is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1033652862
Provider Type
Individual
Full Name
Mick, Michelle R
Credential
ANP-C

Gender
Female
Sole Proprietor
No
Enumeration Date
11/28/2016
Last Updated
10/12/2023

Contact Information

Practice Location

3015 N Ballas Rd, Saint Louis, MO 63131-2329

(314) 996-5772

Unlisted Fax

Mailing Location

3015 N Ballas Rd, Saint Louis, MO 63131-2329

(314) 996-5772

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 2016035597 Missouri
Code 363LA2200X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 2016035597 Missouri

Michelle R Mick

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Go Health And Wellness

Hudson, Latania

Akinsete, Adetoun A

Mccammon, Jean R

Tench, Cynthia C

Woodsmall, Jaymie L

Lemp, Shannon E

Effland, Lori A

Sebalja, Emily

Molitor, John William