Doctor Name: | MARY C MIELE |
NPI Number: | 1306187307 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | 2013007226 |
Business Practice Address: | 950 N Jesse James Rd Excelsior Springs, MO - 640241238 |
Business Phone Number: | 8166306071 |
Business Fax Number: | |
Mailing Address: | Po Box 219672, KANSAS CITY |
State: | MO |
Postal Code: | 641219672 |
Phone Number: | 8167697213 |
Fax Number: | |
NPI Enumeration Date: | 03/15/2013 |
NPI Last Update Date: | 09/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2013007226 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |