Provider Demographics
NPI:1386619138
Name:NOBS, MICHELE A (NP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:A
Last Name:NOBS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:607 S NEW BALLAS RD
Mailing Address - Street 2:SUITE 3300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8219
Mailing Address - Country:US
Mailing Address - Phone:314-251-4986
Mailing Address - Fax:314-251-6375
Practice Address - Street 1:607 S NEW BALLAS RD
Practice Address - Street 2:SUITE 3300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8219
Practice Address - Country:US
Practice Address - Phone:314-251-4986
Practice Address - Fax:314-251-6375
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2014-11-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO066498363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO427468202Medicaid
MO825813586Medicare PIN
MO427468202Medicaid