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General NPI Number Information
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NPI Number | 1427886209
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Entity Type | Individual
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Provider Name | MICKEY MICHELLE FOX FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/23/2024
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 12830 HESPERIA RD STE A-D
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City | VICTORVILLE
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State | CA
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Zip | 92395-7788
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Country | US
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Telephone | 760-684-8999
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Fax | 760-684-8111
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Provider Business Mailing Address
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Address Line | 12830 HESPERIA RD STE A-D
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City | VICTORVILLE
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State | CA
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Zip | 92395-7788
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Country | US
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Telephone | 760-684-8999
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Fax | 760-684-8111
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95031507
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 95109643
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License Number State | CA
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