Michelle Bobbett
Individual provider Active NPI Pharmacist · Ironton, MO
NPI 1053978643 · NPPES record last updated May 20, 2019
Key facts
- NPI
- 1053978643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2005022605 (MO)
- Practice address
- 605 N Main St
Ironton, MO 63650-1006 - Phone
- (573) 546-7915
- NPI assigned
- May 20, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005022605 | MO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2005022605 | MO | Yes |
Addresses
Primary practice location
605 N Main St
Ironton, MO 63650-1006
Mailing address
605 N Main St
Ironton, MO 63650-1006
Phone (573) 546-7915
Other providers in Ironton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.