Basic Information
| Provider Information | |||||||||
| NPI: | 1336170927 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MIDKIFF | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | RN MSN APNC NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 PRYTANIA ST STE 35 | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153678 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048978412 | ||||||||
| FaxNumber: | 5048972064 | ||||||||
| Practice Location | |||||||||
| Address1: | 3525 PRYTANIA ST | ||||||||
| Address2: | SUITE 526 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5046482500 | ||||||||
| FaxNumber: | 5048972064 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 04/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN46372 | LA | N | Nursing Service Providers | Registered Nurse | 363A00000X | AP03225 | LA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363LA2200X | AP03225 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 1B9102 | 01 | LA | MEDICARE | OTHER | 1539171 | 05 | LA | MEDICAID |