MEDICARE: MICHELLE MARIE TODERO BSN, DNAP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	RN9463414	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205509114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MARIE TODERO BSN, DNAP

Provider Business Mailing Address
First Line	:	1606 RIVERVIEW DR SE
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30067-4841
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1606 RIVERVIEW DR SE
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30067-4841
Country	:	US
Telephone Number	:	818-321-5261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2021
Last Update Date	:	07/27/2021

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