Healthcare Provider Details

I. General information

NPI: 1427709278
Provider Name (Legal Business Name): MICHELLE LINDSEY VORE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2022
Last Update Date: 01/15/2025
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LOCUST ST PMB 126
DES MOINES IA
50309
US

IV. Provider business mailing address

PO BOX 672
ANKENY IA
50021-0672
US

V. Phone/Fax

Practice location:
  • Phone: 515-805-0956
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG166896
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: