MRS. MELISSA THIBAULT MIKOTA APRN FNP-BC NPI 1346673910

NPI Information

NPI: 1346673910
Provider Name: MRS. MELISSA THIBAULT MIKOTA, APRN, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
34344 N US HIGHWAY 45
THIRD LAKE, IL
ZIP 60030
Phone: (847) 543-5440
Get Directions

MRS. Melissa Thibault Mikota, APRN, FNP-BC is a family nurse practitioner in Third Lake, IL with 12 years of experience. MRS. Melissa Thibault Mikota, APRN, FNP-BC NPI is 1346673910. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

34344 N US HIGHWAY 45
THIRD LAKE, IL
ZIP 60030-031
Phone: (847) 543-5440

The NPI 1346673910 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/18/2013 and was last updated on 6/30/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	AP133930	TEXAS	No
2	363LF0000X	Nurse Practitioner	Family	209010057	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G8923564	OTHER	WASHINGTON	MEDICARE PTAN
2	1346673910	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »