Healthcare Provider Details

I. General information

NPI: 1437373669
Provider Name (Legal Business Name): MRS. MICHELE CADICE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PL
SAINT LOUIS MO
63110-1002
US

IV. Provider business mailing address

1 CHILDRENS PL
SAINT LOUIS MO
63110-1002
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-2079
  • Fax:
Mailing address:
  • Phone: 314-454-6000
  • Fax: 314-454-6000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number107533
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: