MEDICARE: MICHELLE ALLEN FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	2010013174	MO
2	363LF0000X	Family Nurse Practitioner	2010013174	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00702570	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	204795132	OTHER	TAX ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467639278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE ALLEN FNP

Provider Business Mailing Address
First Line	:	PO BOX 957683
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-1981
Country	:	US
Telephone Number	:	573-756-6751
Fax Number	:	573-760-8044

Provider Business Practice Location Address
First Line	:	534 MAPLE VALLEY DR
Second Line	:
City	:	FARMINGTON
State	:	MO
Zip	:	63640-1981
Country	:	US
Telephone Number	:	573-760-8253
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2008
Last Update Date	:	09/26/2025

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Directions to “ MICHELLE ALLEN FNP” Practice Location

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