| Michele D Moldrem, MHNP | |
|
988 N Illinois Route 3, Waterloo, IL 62298 | |
| (619) 393-4444 | |
| Not Available |
| Full Name | Michele D Moldrem |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 988 N Illinois Route 3, Waterloo, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598907545 | NPI | - | NPPES |
| Entity Name | Paragon Clinical Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114139946 PECOS PAC ID: 7214034925 Enrollment ID: O20070515000051 |
| Entity Name | Human Support Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851314918 PECOS PAC ID: 8729166434 Enrollment ID: O20080422000307 |
| Entity Name | Paragon Clinical Midwest Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619335700 PECOS PAC ID: 2860791647 Enrollment ID: O20240305000724 |
| Mailing Address | Practice Location Address |
|---|---|
| Michele D Moldrem, MHNP 988 N Illinois Route 3, Waterloo, IL 62298-1059 Ph: (618) 939-4444 | Michele D Moldrem, MHNP 988 N Illinois Route 3, Waterloo, IL 62298 Ph: (619) 393-4444 |
Mr. Matthew Robert Jones, ACNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 509 Hamacher St Ste 202, Waterloo, IL 62298 Phone: 618-939-4200 Fax: 618-939-4256 | |
Courtney Mccarty, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 224 Bradford Ln, Waterloo, IL 62298 Phone: 618-939-0112 Fax: 618-939-0119 | |
Ms. Carol Ann Glascock, APNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 723 Station Xing, Waterloo, IL 62298 Phone: 618-939-1551 Fax: 618-939-1553 | |
Megan Roberts, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 224 Bradford Ln, Waterloo, IL 62298 Phone: 618-939-0112 | |
Shanna Witges, APRN NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 509 Hamacher St Ste 102, Waterloo, IL 62298 Phone: 618-939-3939 | |
Dr. Megan Lutman, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 921 Kimberly Ln, Waterloo, IL 62298 Phone: 314-456-6008 | |
Marla Rae Smith, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 869 North Illinois Rt 3, Waterloo, IL 62298 Phone: 618-939-7771 Fax: 618-939-7746 |