Michelle Certik, PA-C
Individual provider Active NPI Medical Physician Assistant · Los Alamos, NM
NPI 1124512207 · NPPES record last updated Jun 21, 2018
Key facts
- NPI
- 1124512207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA2018-0034 (NM)
- Practice address
- 3917 West Rd Ste a
Los Alamos, NM 87544-2292 - Phone
- (505) 661-8900
- Fax
- (505) 661-8916
- NPI assigned
- Jun 21, 2018
- 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)
- Yes
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA2018-0034 | NM | Yes |
Addresses
Primary practice location
3917 West Rd Ste a
Los Alamos, NM 87544-2292
Mailing address
3917 West Rd Ste a
Los Alamos, NM 87544-2292
Phone (505) 661-8900
Other providers in Los Alamos, NM
- Casa Mesita Group Home, Inc
- Desiree Cassell
- Elizabeth Turner Castilla
- Araceli Maria Castillo
- Roseli Cavalcante
- Olivia M Chandler
- Shashi Charles
- Susana T. Chavarria
- Yushu Cheng
- Childrens Clinic, P.a.
All providers in Los Alamos, NM · Medical Physician Assistant in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2018. 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.