| Doctor Name: | MICHAEL DAVE MCVICKER |
| NPI Number: | 1023011343 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP-BC |
| License Number: | RN120320 |
| Business Practice Address: | 220 North Elm Street Mountain View, MO - 655480032 |
| Business Phone Number: | 4179342273 |
| Business Fax Number: | 4179342332 |
| Mailing Address: | Hc 67 Box 76, MOUNTAIN VIEW |
| State: | MO |
| Postal Code: | 655489005 |
| Phone Number: | 4179345055 |
| Fax Number: | |
| NPI Enumeration Date: | 05/31/2005 |
| NPI Last Update Date: | 07/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN120320 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |