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General NPI Number Information
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NPI Number | 1245017888
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Entity Type | Individual
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Provider Name | MICAYLA AMICK
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Gender | Female
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Dates
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Enumeration Date | 09/08/2023
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 3600 30TH ST
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City | DES MOINES
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State | IA
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Zip | 50310-5753
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Country | US
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Telephone | 515-341-1368
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Fax |
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Provider Business Mailing Address
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Address Line | 713 SE 3RD ST
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City | GRIMES
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State | IA
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Zip | 50111-1010
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Country | US
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Telephone | 515-341-1368
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 148547
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G186915
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License Number State | IA
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