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).
| 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 |
| 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 |
| Street Address |
303 E BASELINE RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85042-6530 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 85042 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| 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 |
| Find all providers in PHOENIX | ||||
Please comment or provide details below to improve the information on BOBBY JEAN MICKENS.
| 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.