MICHELLE DEZURA ANTHONY NP NPI 1649314220

NPI Information

NPI: 1649314220
Provider Name: MICHELLE DEZURA ANTHONY, NP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
5125 SKYLINE RD S
SALEM, OR
ZIP 97306
Phone: (503) 315-4663
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Michelle Dezura Anthony, NP is an adult health nurse practitioner in Salem, OR with 23 years of experience. Michelle Dezura Anthony, NP NPI is 1649314220. 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:

5125 SKYLINE RD S
SALEM, OR
ZIP 97306-427
Phone: (503) 315-4663

The NPI 1649314220 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 2/16/2007 and was last updated on 3/10/2022.

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	363LA2100X	Nurse Practitioner	Acute Care	RN79000	LOUISIANA	No
2	363LA2100X	Nurse Practitioner	Acute Care	AP04978	LOUISIANA	No
3	363LA2200X	Nurse Practitioner	Adult Health	AP60436588	WASHINGTON	No
4	363LA2200X	Nurse Practitioner	Adult Health	201392913NP-PP	OREGON	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	1013889	MEDICAID	LOUISIANA
2	00754042	MEDICAID	MISSISSIPPI

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

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