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General NPI Number Information
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NPI Number | 1972172534
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Entity Type | Individual
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Provider Name | VICKY N MICHEL APRN
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Gender | Female
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Dates
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Enumeration Date | 06/18/2021
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Last Update Date | 06/18/2021
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Provider Practice Location Address
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Address Line | 2215 NEBRASKA AVE STE 2-B
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City | FORT PIERCE
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State | FL
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Zip | 34950-4866
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Country | US
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Telephone | 772-302-3767
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Fax |
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Provider Business Mailing Address
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Address Line | 2411 SW BRESCIA ST
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-2756
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11008359
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License Number State | FL
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