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DEIRDRE MAE MICKER N.P. NPI 1467622084


NPI Information

NPI: 1467622084
Provider Name: DEIRDRE MAE MICKER, N.P.
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
9 HDSN VLY PROF PLZ
NEWBURGH, NY
ZIP 12550
Phone: (845) 561-0990
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Deirdre Mae Micker, N.P. is a family nurse practitioner in Newburgh, NY with 29 years of experience. Deirdre Mae Micker, N.P. NPI is 1467622084. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
Graduation Year:1995

The provider's business location address is:

9 HDSN VLY PROF PLZ
NEWBURGH, NY
ZIP 12550-150
Phone: (845) 561-0990
Fax: (845) 562-1439

The NPI 1467622084 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 3/11/2008 and was last updated on 7/19/2021.


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
1363L00000XNurse PractitionerF420349NEW YORKNo
2363LF0000XNurse PractitionerFamilyF420349NEW YORKYes
3363LW0102XNurse PractitionerWomen's HealthF420349NEW YORKNo

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
102462962MEDICAIDNEW YORK

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: 5/5/2024

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.