Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 2013026355 | MO |
N | 363LA2100X | Nurse Practitioner - Acute Care | 2018043572 | MO |
N | 363LA2200X | Nurse Practitioner - Adult Health | 2018043572 | MO |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 2018043572 | MO |
N | 363LG0600X | Nurse Practitioner - Gerontology | 2018043572 | MO |
NPI | 1417427717 |
---|---|
Provider Name | Ms. Michelle J Gay |
First Address | Columbia, MO 65201-5897 |
Second Address | Columbia, MO 65201-5844 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2018 |
Last Update Date | 19/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2018078938 | ADULT GERONTOLOGY ACUTE CARE NURSE PRACTITIONER (AGACNP-BC) - ANCC (01) | |
420065519 | (05) | MO |