Michele Depalma, NP

Individual provider Active NPI Family Nurse Practitioner · Forsyth, MO

NPI 1154869550 · NPPES record last updated Feb 6, 2017

Key facts

NPI
1154869550
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
2017003055 (MO)
Practice address
256 State Highway Y
Forsyth, MO 65653-5618
Phone
(417) 546-4200
Fax
(417) 546-4505
NPI assigned
Feb 6, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20170413001484 MO Order and Referring Only - Nurse Practitioner 9931485596

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2017003055 MO Yes

Addresses

Primary practice location

256 State Highway Y
Forsyth, MO 65653-5618

Mailing address

256 State Highway Y
P.O. Box 1240
Forsyth, MO 65653-5618
Phone (417) 546-4200

Other providers in Forsyth, MO

All providers in Forsyth, MO · Family Nurse Practitioner in Missouri

Sources for this page

Verify at the official NPI Registry.