Provider Demographics
NPI:1366910424
Name:MICHEL, DAGNY (APN, CNP)
Entity type:Individual
Prefix:
First Name:DAGNY
Middle Name:
Last Name:MICHEL
Suffix:
Gender:F
Credentials:APN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 S SAMPSON ST
Mailing Address - Street 2:
Mailing Address - City:TREMONT
Mailing Address - State:IL
Mailing Address - Zip Code:61568-8035
Mailing Address - Country:US
Mailing Address - Phone:309-929-2030
Mailing Address - Fax:309-929-2060
Practice Address - Street 1:123 S SAMPSON ST
Practice Address - Street 2:
Practice Address - City:TREMONT
Practice Address - State:IL
Practice Address - Zip Code:61568-8035
Practice Address - Country:US
Practice Address - Phone:309-929-2030
Practice Address - Fax:309-929-2060
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277002722363LP0808X
IL277002201363LF0000X
IL209018449363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner