Healthcare Provider Details

I. General information

NPI: 1902727068
Provider Name (Legal Business Name): MICHELLE A. LABIANCA BRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2364 S 2ND ST
EL CENTRO CA
92243-9642
US

IV. Provider business mailing address

2364 S 2ND ST
EL CENTRO CA
92243-9642
US

V. Phone/Fax

Practice location:
  • Phone: 760-332-3303
  • Fax: 760-332-1463
Mailing address:
  • Phone: 760-332-3303
  • Fax: 760-332-1463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95347932
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: