ABI MIKKEL PROVENCE (NPI# 1922587872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922587872 |
| Entity Type | Individual |
| Full Name | ABI MIKKEL PROVENCE |
| Credential | MSN, FNP-BC & FNP-C |
| Practice Address |
4740 W University Dr Ste 190 Prosper TX 75078-9092 |
| Mailing Address |
Po Box 170428 Arlington TX 76003-0428 |
| Practice Telephone | 4697164950 |
| Practice Fax Number | 4697164950 |
| Mailing Telephone | 8177297853 |
| Enumeration Date | 2018-08-11 |
| Last Update Date | 2019-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
AP138443 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1811 Highway 287 N, Mansfield, TX 760637571 |
| Street Address |
4740 W UNIVERSITY DR STE 190 |
| City | PROSPER |
| State | TX |
| Zip Code | 75078-9092 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932734936 | Qnpham, Pllc | Optometrist | 4940 W. University Dr, Prosper, TX 75078 | 2020-03-10 |
| 1518592005 | Ferrari Orthodontics Pllc | Dentist | 1921 N Preston Rd, Proper, TX 75078 | 2020-03-05 |
| 1629538814 | 380 Smiles Pllc | Clinic/Center | 4940 W. University Dr., Suite 40, Prosper, TX 75078 | 2019-03-22 |
| 1558849158 | Samuel Oh Dmd Pllc | Dentist | 17569 Fishtrap Rd, Ste 80, Prosper, TX 75078 | 2018-08-06 |
| 1003303736 | National Vision, Inc. | Technician/Technologist | 871 South Preston Road, Prosper, TX 75078 | 2018-04-18 |
| 1265934749 | Lumincare Physician Group, Pa | Family Medicine | 1000 North Preston Road Suite 60, Prosper, TX 75078 | 2018-03-01 |
| 1164948436 | Dental Office of Prosper,pc | Dentist | 1180 N Preston Rd Suite 20, Prosper, TX 75078 | 2017-08-18 |
| 1750805602 | Texas Dental Surgery | Dentist | 1180 N Coit Rd Ste 40, Prosper, TX 75078 | 2017-08-02 |
| 1285168039 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 500 Richland Boulevard, Prosper, TX 75078 | 2017-04-19 |
| 1679024897 | Cvs Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 2451 E. University Drive, Prosper, TX 75078 | 2016-10-24 |
| Find all providers in zip 75078 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740588 | Jessica Claudia Cazaubon | Nurse Practitioner | 13327 Crim Rd, Houston, TX 77049-3448 | 2020-11-04 |
| 1629679147 | Magdoleen Awad | Nurse Practitioner | 1602 Morning Dove Ct, Carrollton, TX 75007-1462 | 2020-11-02 |
| 1215536131 | Linnet Litakuli Nandwa | Nurse Practitioner | 6509 Sheerwater Rd, Arlington, TX 76002-3680 | 2020-10-21 |
| 1902405301 | Texas Suburban Visiting Physician Services | Nurse Practitioner | 2200 Smith Barry Rd, Pantego, TX 76013-5800 | 2020-10-19 |
| 1437757432 | Katie Jo Dixon | Nurse Practitioner | 4300 Speedway Unit 4775, Austin, TX 78765-2032 | 2020-10-12 |
| 1376140954 | Melissa Kujawski | Nurse Practitioner | 332 Enid Dr, Lewisville, TX 75056-5874 | 2020-10-06 |
| 1952908188 | Sari Alhaik | Nurse Practitioner | 411 Park Grove Dr Ste 620, Katy, TX 77450-1576 | 2020-10-01 |
| 1669089421 | Heather Ann Votion | Nurse Practitioner | 4501 S General Bruce Dr Ste 75, Temple, TX 76502-1466 | 2020-09-25 |
| 1245847318 | Xin Peng | Nurse Practitioner | 707 Walsh Hill Trl, Cedar Park, TX 78613-4855 | 2020-09-23 |
| 1194331470 | Clara Dornisha Green | Nurse Practitioner | 5847 Acacia Cir Apt 1816, El Paso, TX 79912-4881 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
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| 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.