Provider Demographics
NPI:1871377150
Name:JOOS, MICHELLE LYNN (FNP-BC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:JOOS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LYNN
Other - Last Name:JANES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:435 MAXINE DR
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:IL
Mailing Address - Zip Code:61550-2498
Mailing Address - Country:US
Mailing Address - Phone:309-284-2209
Mailing Address - Fax:309-263-7273
Practice Address - Street 1:435 MAXINE DR
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:IL
Practice Address - Zip Code:61550-2498
Practice Address - Country:US
Practice Address - Phone:309-284-2209
Practice Address - Fax:309-263-7273
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.028084363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily