BOBBY JEAN MICKENS


Address: 303 E Baseline Rd, Phoenix, AZ 85042-6530
Phone: 0224372776

BOBBY JEAN MICKENS (NPI# 1558773028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1558773028
Entity Type Individual
Full Name BOBBY JEAN MICKENS
Credential NP
Practice Address 303 E Baseline Rd
Phoenix
AZ 85042-6530
Mailing Address 3003 N Central Ave Ste 1600
Phoenix
AZ 85012-2908
Practice Telephone 0224372776
Practice Fax Number 6022764427
Mailing Telephone 6023233344
Mailing Fax Number 6023233496
Enumeration Date 2014-06-02
Last Update Date 2020-07-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363L00000X Nurse Practitioner 2006020259 MO Physician Assistants & Advanced Practice Nursing Providers
Y 363LW0102X Nurse Practitioner
Specialization: Women's Health
241811 AZ Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 303 E BASELINE RD
City PHOENIX
State AZ
Zip Code 85042-6530

Providers in the same location

NPI Name Taxonomy Address Enumeration
1962474668 Mary Elizabeth Vaughan Nurse Practitioner 303 E Baseline Rd, Suite 203, Phoenix, AZ 85042-6530 2006-02-06
1801362892 Sarah Joyce Tucker Nurse Practitioner 303 E Baseline Rd, Phoenix, AZ 85042-6530 2018-10-17
1811490881 Mountain Park Health Center Clinic/Center 303 E Baseline Rd, Phoenix, AZ 85042-6530 2018-03-15
1457720765 Rachel Kennamer Nurse Practitioner 303 E Baseline Rd, Phoenix, AZ 85042-6530 2015-09-16
1124441944 Spooner Physical Therapy & Hand Rehab, PC Physical Therapist 303 E Baseline Rd, Ste 101, Phoenix, AZ 85042-6530 2014-01-30
1144642653 Trent Brooke Physical Therapist 303 E Baseline Rd, Ste 110, Phoenix, AZ 85042-6530 2014-01-17
1144658154 Matthew Getz Physical Therapist 303 E Baseline Rd, Suite 110, Phoenix, AZ 85042-6530 2013-10-30
1831434620 Amy Mainelli Physical Therapist 303 E Baseline Rd, Suite 110, Phoenix, AZ 85042-6530 2012-12-05
1477807485 Spooner Phoenix Physical Therapy, Inc. Physical Therapist 303 E Baseline Rd, Suite 110, Phoenix, AZ 85042-6530 2012-10-30
1487901963 Vilawoe Aku Boadu Pharmacist 303 E Baseline Rd, Suite #100, Phoenix, AZ 85085 2012-08-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1306443197 Da Homes LLC Case Management 8026 S. 24th Way, Phoenix, AZ 85042 2020-10-05
1144790460 Ebony House Inc Substance Abuse Rehabilitation Facility 6222 S. 13th Street, Phoenix, AZ 85042 2018-11-29
1427538362 Abigail Mcgrath Dietitian, Registered 303 E Baseline Rd Ste 200, Phoenix, AZ 85042 2018-08-20
1174028310 Olufemi A Omodara Pharmacist 7227 S. Central Ave, #1080, Phoenix, AZ 85042 2018-03-29
1720537699 Mary Youngblood Registered Nurse 7210 S 27th Way, Phoenix, AZ 85042 2016-10-03
1922490382 Brian Zembower Optometrist 610 E Baseline Rd Ste C3, Phoenix, AZ 85042 2015-02-23
1417299819 Robert Murphy Portley Psychiatry & Neurology 2320 E Baseline Rd Ste 148-225, Phoenix, AZ 85042 2013-03-23
1972807998 Obinna Chukwuka Akubukwe Pharmacist 6006 S. Central Avenue, Phoenix, AZ 85042 2011-01-05
1104120328 Gisheys Patient Care LLC Custodial Care Facility 7232 South 12th Place, Phoeniz, AZ 85042 2011-01-03
1245463488 Lois Ann Hammitt Registered Nurse 6218 S. 7th Street, Phoenix, AZ 85042 2009-09-03
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Taxonomy Information

Taxonomy Code 363LW0102X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Women's Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962018952 Marlene Hildegard Zeller Nurse Practitioner 16630 S 38th Pl, Phoenix, AZ 85048-7944 2020-09-16
1962034355 Jessica Lynn Contreras Nurse Practitioner 6704 N 10th Ave, Phoenix, AZ 85013-1008 2020-02-04
1437442076 Mary Franice Dunn Nurse Practitioner 2222 E. Highland Ave Ste. 220, Kronos Longevity Research Institute, Phoenix, AZ 85016-4876 2011-05-16
1831418763 Pamela Barbour Peat Nurse Practitioner 3125 N 32nd St Ste 200, Phoenix, AZ 85018-6218 2010-05-17
1851505887 Jennifer Spiser Woodruff Nurse Practitioner 9930 W Indian School Rd, Phoenix, AZ 85037-5902 2007-05-09
1679793780 Sherry Lee Gorslin Nurse Practitioner 9303 N 7th St, Ste 4, Phoenix, AZ 85020 2007-04-30
1497876056 Bonnie Rose Hare Nurse Practitioner 1661 E. Camelback Road, Ste 160, Phoenix, AZ 85016 2007-04-02
1750468138 Traci Rae Aldridge Nurse Practitioner 11209 N. Tatum Blvd, Suite 255, Phoenix, AZ 85028 2006-11-01
1538190269 Debra Laseter Nurse Practitioner 2255 N 44th St, Suite #200, Phoenix, AZ 85008-3293 2006-07-05
1588665061 Joyce Morgan Nurse Practitioner 6601 W Thomas Rd, Phoenix, AZ 85033-5700 2005-08-09
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Competitor

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City PHOENIX
Zip Code 85042

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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