Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Menichino, NP

Individual provider Registered Nurse · NPI 1053902627

Nicole Menichino, NP is a Nurse Practitioner in Chesterfield, Missouri. Qualified in 2020, 6 years ago. Practices with Complex Illness Management of St Lukes LLC, a 6-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
6
Licensed in
MO
In the registry since
2021
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

16216 Baxter Rd Ste 100
Chesterfield, MO 63017-4778
Phone: (636) 449-4700
Fax: (636) 449-2595
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2021004371 (MO)
Registered Nurse Taxonomy 163W00000X · Licence 2016004551 (MO)

Record details

NPI number1053902627
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJanuary 27, 2021
Last updated in NPPESFebruary 4, 2021
Certification dateFebruary 4, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Complex Illness Management Of St Lukes Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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