IndividualActive
Michael Pieschel
NPI 1639039936 · Gerontology Clinical Nurse Specialist · O Fallon, IL
Provider details
- NPI number
- 1639039936
- Entity type
- Individual
- Primary specialty
- Gerontology Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 209.033858 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1 Saint Elizabeth Blvd # 3000
O Fallon, IL 62269-1099
Phone: (618) 234-2120
Approximate (ZIP-level) locationGet directions
Mailing address
397 Blue Bird Ln
Troy, IL 62294-2109
Registry dates
- Enumerated
- 2025-11-18
- Last updated
- 2025-11-18
- Certified
- 2025-11-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.