Healthcare Provider Details

I. General information

NPI: 1659134047
Provider Name (Legal Business Name): MICHELE COMISKEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2044 TRINITY OAKS BLVD STE 210
TRINITY FL
34655-4406
US

IV. Provider business mailing address

8643 CREEDMOOR LN
NEW PORT RICHEY FL
34654-4631
US

V. Phone/Fax

Practice location:
  • Phone: 727-359-2487
  • Fax:
Mailing address:
  • Phone: 727-364-4793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11028876
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: