Provider Demographics
NPI:1568228435
Name:THE PREMIER NP
Entity Type:Organization
Organization Name:THE PREMIER NP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:772-801-3497
Mailing Address - Street 1:2895 SW CEDAR DUNES DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-4571
Mailing Address - Country:US
Mailing Address - Phone:772-801-3497
Mailing Address - Fax:
Practice Address - Street 1:2895 SW CEDAR DUNES DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-4571
Practice Address - Country:US
Practice Address - Phone:772-801-3497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty