Healthcare Provider Details

I. General information

NPI: 1417020538
Provider Name (Legal Business Name): MICHELLE STEMPEL MACIONE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE STEMPEL M.C.D.

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 08/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2238 GAUSE BLVD E UNIT A
SLIDELL LA
70461-4231
US

IV. Provider business mailing address

6700 WASHINGTON AVE S
EDEN PRAIRIE MN
55344-3405
US

V. Phone/Fax

Practice location:
  • Phone: 985-649-9131
  • Fax: 985-649-9498
Mailing address:
  • Phone: 800-328-8602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number5375
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: