Michelle C Brown, RNCPNP
Individual provider Active NPI Pediatric Nurse Practitioner · Arnold, MO
NPI 1659889244 · NPPES record last updated Mar 14, 2023
Key facts
- NPI
- 1659889244
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 2017038961 (MO)
- Practice address
- 3530 Jeffco Blvd Ste 110
Arnold, MO 63010-6101 - Phone
- (314) 467-3800
- NPI assigned
- Jan 17, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230320000535 | MO | Order and Referring Only - Nurse Practitioner | 5395119143 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017038961 | MO | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ccpartners LLC | Past | Accepting new patients | |
| Mercy Hospitals East Communities | Past |
Accepting new patients | |
| Mercy Clinic East Communities | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 2017038961 | MO | Yes |
Addresses
Primary practice location
3530 Jeffco Blvd Ste 110
Arnold, MO 63010-6101
Mailing address
PO Box 776084
Chicago, IL 60677-6084
Phone (314) 364-7586
Other practice location 1
35 Goodwin Dr
Festus, MO 63028-4122
Phone (636) 933-4141
Other practice location 2
1309 Maple St
Farmington, MO 63640-7641
Phone (573) 756-4343
Other providers in Arnold, MO
- Jamie Lynne Brockmeier
- Madeline Anne Broekelmann
- Brooks Chiropractic & Wellness LLC
- Casey Brooks
- Emily Brouk
- Jennifer Brumfield
- Valerie Buckley
- Jacqueline Marie Budde
- Garrett R Buechler
- Jennifer Bullock-Wells
All providers in Arnold, MO · Pediatric Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.