Miss Ericka M Micou
Nurse Practitioner - Community Health
1134 Winter St
Jackson
, Mississippi 39204-2841
Miss Ericka M Micou
Nurse Practitioner - Community Health
1134 Winter St
Jackson
, Mississippi 39204-2841
(601) 914-3012
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About
Features
Specialties
- Nurse Practitioner - Community Health
Languages spoken
- English
Location
First Address
- Miss Ericka M Micou
- 1134 Winter St
- Jackson, MS
- Zip : 39204-2841
- Fax : (601) 914-3012
- Phone : (601) 948-5572
Second Address
- Miss Ericka M Micou
- 1134 Winter St
- Jackson, MS
- Zip : 39204-2841
- Fax : (601) 914-3012
- Phone : (601) 948-5572
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Is Miss Ericka M Micou a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LC1500X | Nurse Practitioner - Community Health | 363L00000X | MS |
National Provider Identifier
| NPI | 1568598027 |
|---|---|
| Provider Name | Miss Ericka M Micou |
| First Address | Jackson, MS 39204-2841 |
| Second Address | Jackson, MS 39204-2841 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/02/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 07450365 | (05) | MS |
| Q24298 | (02) | MS |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.