SUSAN E MITCHELL-DERENSKI


Address: 20 Progress Point Pkwy, Ste 100, O Fallon, MO 63368-2206
Phone: 6363443105

SUSAN E MITCHELL-DERENSKI (NPI# 1629329578) 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) 1629329578
Entity Type Individual
Full Name SUSAN E MITCHELL-DERENSKI
Other Name SUSAN E MITCHELL
Credential WHNP
Practice Address 20 Progress Point Pkwy
Ste 100
O Fallon
MO 63368-2206
Mailing Address 670 Mason Ridge Center Dr
Ste 300
Saint Louis
MO 63141-8573
Practice Telephone 6363443105
Practice Fax Number 6363443104
Mailing Telephone 6363443105
Mailing Fax Number 6363443104
Enumeration Date 2012-10-01
Last Update Date 2015-11-24
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 2006026079 MO Nursing Service Providers
Y 363LW0102X Nurse Practitioner
Specialization: Women's Health
2012036251 MO Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 20 PROGRESS POINT PKWY
STE 100
City O FALLON
State MO
Zip Code 63368-2206

Providers in the same location

NPI Name Taxonomy Address Enumeration
1649273160 Stephanie L Sandberg Internal Medicine 20 Progress Point Pkwy, Suite 206, O Fallon, MO 63368-2206 2005-05-30
1821500778 Washington University Durable Medical Equipment & Medical Supplies 20 Progress Point Pkwy, O Fallon, MO 63368-2206 2017-11-01
1477910461 Angela C Clercx Registered Nurse 20 Progress Point Pkwy, Ste 108, O Fallon, MO 63368-2206 2016-01-21
1366830572 Wuca-o'fallon Pediatrics, LLC Pediatrics 20 Progress Point Pkwy, Suite 220, O Fallon, MO 63368-2206 2014-12-23
1841612850 Emily Suzanne Hammer Nurse Practitioner 20 Progress Point Pkwy, Suite 200, O Fallon, MO 63368-2206 2014-01-09
1417211756 Nikol Lei Smart Obstetrics & Gynecology 20 Progress Point Pkwy, Ste 206, O Fallon, MO 63368-2206 2012-07-02
1942513205 Catherine L Crass Nurse Practitioner 20 Progress Point Pkwy, Suite 200, O Fallon, MO 63368-2206 2010-07-15
1578875647 Cory Scott Miller Obstetrics & Gynecology 20 Progress Point Pkwy, Ste 206, O Fallon, MO 63368-2206 2010-07-06
1619100989 Jamie Lee Tueth Internal Medicine 20 Progress Point Pkwy, Ste 108, O Fallon, MO 63368-2206 2009-09-02
1477717080 Milton Oludhe Ochieng' Internal Medicine 20 Progress Point Pkwy, Ste 108, O Fallon, MO 63368-2206 2008-07-12
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134720329 Come As You Are Counseling LLC Counselor 1001 Boardwalk Springs Place, Suite 111, O Fallon, MO 63368 2020-11-04
1770124802 Lisa N. Greer Technician 6911 Brassel Dr., Ofallon, MO 63368 2019-09-30
1770145716 Halie Faye Gulley Dentist 3009 Hwy K, O'fallon, MO 63368 2019-06-29
1972079556 Erin Corsi Fraundorf Dentist 3009 State Hwy K, O'fallon, MO 63368 2018-10-22
1427579960 Air Evac Ems, Inc. Ambulance 1001 Boardwalk Springs Pl Ste 250, O Fallon, MO 63368 2017-07-06
1528507472 Washeck Manual Therapy LLC Clinic/Center 3074 Winghaven Blvd, O'fallon, MO 63368 2017-02-13
1639618457 Brittany Hogan Physical Therapist 7412 South Outer 364, Suite B, Dardenne Prairie, MO 63368 2017-02-13
1124561469 Cardinal Home Care LLC Home Health 18 Convent Garden Ct, O'fallon, MO 63368 2016-11-18
1336509272 Sarah Marie Mudd Counselor 1654 Bryan Road, O'fallon, MO 63368 2016-03-04
1588023956 Price-bourisaw Family Chiropractic Chiropractor 2917 State Highway K, O Fallon, MO 63368 2016-02-15
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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
1841612850 Emily Suzanne Hammer Nurse Practitioner 20 Progress Point Pkwy, Suite 200, O Fallon, MO 63368-2206 2014-01-09
1942513205 Catherine L Crass Nurse Practitioner 20 Progress Point Pkwy, Suite 200, O Fallon, MO 63368-2206 2010-07-15

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1356956304 Andrea Marie Sleeth Nurse Practitioner 3329 W Sexton St, Springfield, MO 65810-1080 2020-09-15
1972112720 Amy Elizabeth Richardson Nurse Practitioner 306 E Summit St, Doniphan, MO 63935-1332 2020-07-28
1417578873 Saskia Naomi Chaskelson Nurse Practitioner 1309 Louisville Ave, Saint Louis, MO 63139-3421 2020-04-27
1811531395 Melanie Melissa Miranda Nurse Practitioner 23 Clayton Ter, Frontenac, MO 63131-2920 2019-10-29
1902450695 Erica Walter Nurse Practitioner 4590 Childrens Pl Fl 4, Saint Louis, MO 63110-1020 2019-07-31
1285288274 Megan Cecile Johnson Nurse Practitioner 7924 Ne 53rd St, Kansas City, MO 64119-4149 2019-07-28
1255839916 Valerie Latrice Johnson Nurse Practitioner 2796 N Lindbergh Blvd, Florissant, MO 63033-1402 2018-01-29
1801305677 Courtney E Turnbough Nurse Practitioner 621 S New Ballas Rd Ste 2002b, Saint Louis, MO 63141-8265 2017-09-25
1710357280 Terri Lablance Nurse Practitioner 3905 Bernard Powell Dr, Kansas City, MO 64127-3427 2015-09-28
1932443058 Catherine Griffin Nurse Practitioner 33 Ayrshire Rd., St. Charles, MO 63303-3129 2012-11-15
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Competitor

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City O FALLON
Zip Code 63368

Improve Information

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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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