Michelle Whited, RN

Individual provider Active NPI Registered Nurse · Pilot Knob, MO

NPI 1013321371 · NPPES record last updated Jun 16, 2014

Key facts

NPI
1013321371
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
2013020014 (MO)
Practice address
200 Saint Mary St.
Pilot Knob, MO 63663
Phone
(573) 327-9803
NPI assigned
Jun 16, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2013020014MOMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2013020014 MO Yes

Addresses

Primary practice location

200 Saint Mary St.
Pilot Knob, MO 63663

Mailing address

PO Box 506
Park Hills, MO 63601-0506

Other providers in Pilot Knob, MO

All providers in Pilot Knob, MO · Registered Nurse in Missouri

Sources for this page

Verify at the official NPI Registry.