Provider Demographics
NPI:1528600186
Name:MISSKERG, MICHELLE (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MISSKERG
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:RECKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:568 NJ-10
Mailing Address - Street 2:SUITE 3-5
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981
Mailing Address - Country:US
Mailing Address - Phone:973-535-8355
Mailing Address - Fax:
Practice Address - Street 1:568 NJ-10
Practice Address - Street 2:SUITE 3-5
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981
Practice Address - Country:US
Practice Address - Phone:973-595-8355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00965000363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner